慢性胰腺炎 189例诊治分析(英文)

Diagnosis and treatment of 189 patients with chronic pancreatitis

目的 总结慢性胰腺炎的诊断和治疗经验。方法 回顾性分析 1983～ 1999年 8月收治的 189例慢性胰腺炎病例资料。 结果 本组患者平均年龄 48 4岁 ,高峰发病年龄为 40～ 6 0岁 ,男∶女为 2 1∶1。发病 1年内确诊率5 1 3% ,5年确诊率 80 4%。CT和ERCP诊断阳性率较高 ,分别为 71 9%和 76 9% ,PABA阳性率为 6 9 7%。 136例患者接受了手术治疗 ,术后并发症发生率为 0 0 1% ,1例患者因胰瘘、腹腔感染、败血症于术后第 7天死亡。术后 97 8%的患者主诉腹痛明显减轻。 结果 慢性胰腺炎早期诊断有一定困难 。

Objectives To summarize the experiences in the diagnosis and treatment of chronic pancreatitis and to improve the management of this disease. Methods One hundred and eighty nine patients with chronic pancreatitis admitted to our hospital from 1983 to August 1999 were reviewed, and the relevant clinical data were analyzed. Results The average age of the patients was 48 years old, with a male to female ratio of 2 1∶1. Around half of the patients were confirmed to have chronic pancreatitis by using multiple methods within a year. They accounted for four fifths of the patients finally diagnosed within the first five years. The positive rate of diagnosis for CT and ERCP was 71 9% and 76 9% respectively, and for PABA was 69 7%. Three fourths (136/189) of the patients with chronic pancreatitis were eventually subjected to surgical interventions. Surgical complications were rare; only one patient died of infection due to pancreatic leakage 7 days after operation. Most patients (98%) showed alleviation of symptoms, pain in particular, after surgical treatment. Conclusions Early diagnosis of chronic pancreatitis is considerably difficult. It is crucial to select various surgical strategies at a proper time point for chronic pancreatitis patients in order to change the natural course of the disease and further improve their life quality.