儿童慢性胰腺炎10例诊治分析

Diagnosis and Treatment Analysis of Ten Cases of Chronic Pancreatitis in Children

目的:探讨儿童慢性胰腺炎的诊断与治疗经验。方法:本文回顾性分析了2015年1月至2023年1月新疆医科大学第一附属医院收治的10例慢性胰腺炎患儿的临床资料,包括一般资料、影像学检查资料、治疗方式、随访等情况,并结合相关研究报道,总结分析其诊疗措施。结果:全组患儿临床症状主要以腹痛为主,部分伴有恶心呕吐症状,其中1例伴有1型糖尿病。影像学主要表现为胰管扩张,胰管钙化、结石等征象。10例慢性胰腺炎患儿中的3例行保守治疗,3例行内镜治疗,4例因胰管结石位置大小、胰管扩张程度等原因,并根据个体化情况行不同手术治疗。全组患儿无死亡病例,随访时间3~6个月,治疗后患儿腹痛较前明显改善,伴有糖尿病患儿经治疗后血糖较前控制平稳,其余随访期间无胰腺内外分泌功能不全表现。结论:儿童慢性胰腺炎临床表现主要为反复发作的腹痛,超声、CT、MRCP等影像学检查具有重要诊断意义。其治疗方式尚存在争议,主要采取内科保守治疗、内镜介入治疗、手术治疗三者循序渐进的治疗模式。

Objective: To explore the diagnosis and treatment experience of chronic pancreatitis in children. Method: This article retrospectively analyzed the clinical data of 10 children with chronic pancrea-titis admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2023, including general information, imaging examination data, treatment methods, fol-low-up, etc., and combined with relevant research reports, summarized the diagnosis and treat-ment measures. Results: The main clinical symptoms of the whole group were abdominal pain, and some of them were accompanied by nausea and vomiting. One of them was accompanied by type 1 diabetes. The main imaging manifestations include pancreatic duct dilation, pancreatic duct calcifi-cation, stones, and other signs. Among the 10 children with chronic pancreatitis, 3 underwent con-servative treatment, 3 underwent endoscopic treatment, and 4 underwent different surgical treat-ments based on individual circumstances due to the size of pancreatic duct stones and the degree of pancreatic duct dilation. There was no death case in the whole group, and the follow-up time was 3~6 months. After treatment, the abdominal pain of the children was significantly improved. After treatment, the blood sugar of the children with diabetes was more stable than before. During the rest of the follow-up period, there was no pancreatic insufficiency. Conclusion: The clinical manifes-tation of chronic pancreatitis in children is mainly recurrent abdominal pain, and imaging exami-nations such as ultrasound, CT, and MRCP have important diagnostic significance. The treatment method is still controversial, mainly adopting a gradual treatment mode of conservative internal medicine treatment, endoscopic intervention treatment, and surgical treatment.