超声胃镜与ERCP诊断慢性胰腺炎的对比研究

COMPARATIVE STUDY OF EUS AND ERCP IN DIAGNOSIS OF CHRONIC PANCREATITIS

为探讨超声胃镜 (EUS)及其与ERCP联合应用对慢性胰腺炎的诊断价值 ,回顾分析 1993年 1月～ 2 0 0 1年 5月长海医院收治的慢性胰腺炎 2 6 2例 ,其中同时行ERCP和EUS检查者共 6 0例。EUS检查提示胰腺形态不规则、回声不均匀 ,胰管扩张、狭窄、扭曲 ,胰管结石 ,胰腺钙化 ,胰腺囊肿并诊断为慢性胰腺炎 4 9例 (81 7% ) ;ERCP诊断慢性胰腺炎 5 2例 (86 7% ) ;ERCP发现胰管改变 ,而EUS未见异常 6例 ,两者诊断符合率为 90 % ;ERCP和EUS联合诊断慢性胰腺炎 5 9例 (98 3% ) ,同单独ERCP或EUS检查诊断准确率相比差异有显著性意义(P <0 0 5 )。提示EUS对慢性胰腺炎有较高的诊断特异性和准确性 ,与ERCP联合应用可显著提高诊断准确率 ,有助于慢性胰腺炎的早期诊断。

The purpose of the present study was to assess the diagnostic value of endoscopic ultrasonography(EUS) and ERCP separately and their combination in chronic pancreatitis. There were 262 cases of chronic pancreatitis from January 1993 to May 2001 in our hospital. Among them 60 cases examined by ERCP and EUS were analyzed retrospectively. The constriction and dilatation of main pancreatic duct and pancreatic duct stones were found by EUS. In all, there were 49 patients who diagnosed chronic pancreatitis by EUS and the accuracy rate was 81 7%. On the other hand, there were 52 patients were diagnosed chronic pancreatitis by ERCP and the accuracy rate was 86 7%. There were also 6 patients who diagnosed by ERCP but undiagnosed by EUS, their coincidence rate was 90%. Furthermore, 59 patients were diagnosed by ERCP in combination with EUS and the accuracy rate was 98 3% ( vs sole ERCP or sole EUS respectively, P <0 05). The results show that the diagnostic specificity and accuracy of EUS are high for chronic pancreatitis and it can be used as a useful examination in diagnosis. ERCP combined with EUS can highly improve the diagnostic accuracy of chronic pancreatitis and it would help to find chronic pancreatitis in the earlier period.