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1、中华现代内科学杂志JournalofChineseModernMedicine2008年第5卷第3期·193··论著·慢性胰腺炎临床特征研究(附57例分析)郭静会,张顺财[摘要]目的探讨慢性胰腺炎(chronicpancreatitis,CP)的病因、临床特点、诊断和治疗措施。方法回顾性总结了1993年1月～2007年12月中山医院住院CP患者57例。结果病因中胆源性CP占3816%,酒精性占915%,自身免疫性占118%,代谢性因素高钙血症、高脂血症病因各占1175%,特发性占4911%;临床症状合并腹部疼痛症状占86%,合并吸收不良腹泻占21%,合并糖尿病占14%,合并门
2、脉系统栓塞1175%,合并假性囊肿4014%,合并胰性胸腹腔积液315%;诊断上3816%的CP病理确诊,4014%影像学检查确诊,315%胰腺外分泌功能检查确诊;治疗上4714%内科保守治疗,其中28%胰酶补充治疗,315%止痛药物治疗,118%同时内镜下鼻胆管引流,5216%外科手术治疗,总有效率达8714%。结论我国CP发病原因构成比同国外不同,仍以胆源性CP和特发性CP为主,CP的疼痛治疗困难,需要内科、内镜和外科的综合治疗。[关键词]慢性胰腺炎;病因;临床表现;诊断;治疗[中图分类号]R57612[文献标识码]A[文章编号]1681-6676(2008)03-019
3、3-04Clinicalfeaturesof57patientswithchronicpancreatitisGUOJing2hui,ZHANGShun2cai.DepartmentofGastroenternology,ZhongshanHospitalAffiliatedtoFudanUniversi2ty,Shanghai200032,China[Abstract]ObjectiveToevaluateetiology,clinicalfeature,diagnosisandtreatmentofchronicpancreatitis(CP).MethodsRetros
4、pectiveanalysiswasmadein57casesofCPinZhongshanHospitalfromJanuary1993toDecember2007.ResultsEtiologyincluded3816%ofbiliarydisorders,915%ofalcoholicintake,118%ofauto2immunity,1175%ofhypercalcinemia,1175%ofhyperlipoidemiaand4911%ofidiopatheticfactors.Theclinicalmanifestationswereabdominalpain(
5、86%),diarrhea(21%),diabetesmellitus(14%),embolismofportalveinsystem(115%),pseudocystofpancreas(4014%)andhydrothoraxandascites(315%).Thesepatientswerediag2nosedaccordingtopathologicalfeatures(3816%),imageologicalfeatures(4014%)andpancreaticexocrinefunc2tion(315%).Managementforchronicpancreat
6、itisincludedmedical(4714%)andsurgical(5216%)intervention,witheffectiverate8714%.Somebenefitfrompancreaticenzymessupplement(28%),endoscopetreatment(118%)andanalgetica(315%).ConclusionTheetiologyofchronicpancreatitisinChinaisdifferentfromwest2erncountries.MostofCPinChinaarebiliaryandidiopathi
7、c.Medical,endoscopicandsurgicalproceduresarein2volvedtotreatchronicpancreatitis,especiallyforthereliefofintractablechronicabdominalpain.[Keywords]chronicpancreatitis;etiology;clinicalfeature;diagnosis;therapy慢性胰腺炎(chronicpancreatitis,CP)是指一种的防治及治疗效果是至关重要
