摘要
目的探究成人无腹痛慢性胰腺炎（CP）的治疗方法及其疗效。方法总结近10年CP患者临床资料，分析成人无痛性CP患者治疗措施及疗效。结果成人无痛性CP共56例，成功随访的46例（82．1％）中，男31例，女15例，年龄（51．6±14．5）岁，随访时间（34．5±27．1）个月。（1）CP胰管结石、胰管改变者26例：内镜介入治疗14例，外科手术治疗7例，两者联合治疗3例，保守治疗2例。（2）CP影像学表现为胰腺或腺周占位的18例：均外科手术治疗。以上两组患糖尿病和腹泻症状者均无减少，部分患者一般情况有改善；各1例患者死于胰腺癌。1例胰管结石患者取石术后结石复发。（3）CP胰管改变合并胰腺囊肿者2例：内镜与外科治疗各1例，后者手术后出现胃出血及肝硬化、黄疸，原因不明。结论内镜与外科治疗无痛性CP胰管结石疗效相近，而影像学表现为胰腺或腺周占位的CP则以外科手术为首选，单纯胰管改变患者治疗尚需观察。各种治疗仅可改善部分无痛性CP患者的一般情况；并应加强对无痛性CP患者的随访和定期复查。
Objective To explore the treatments and their effects on painless chronic pancreatitis （CP） in adult. Methods A historical cohort study of adult subjects with CP, who were hospitalized in our center in the last decade, was performed, and the clinical data were analyzed. Results There were 56 cases of adult painless CP, and 46（82. 1% ） （31 males and 15 females, age 51.6 ± 14. 5 years） were followed up（34. 5 ± 27.1 months）. Imaging findings showed 26 cases of pancreatic duct stones and morphological changes. These patients received endoscopic intervention therapy （ n = 14 ） , surgical procedures （ n = 7 ） , combined endoscopic and surgical treatment （ n = 3 ） and conservative treatment （ n = 2 ）. Another group of 18 cases of pancreatic or peripheral occupying lesions received surgery. During follow-up of the above 2 groups, 1 patient died of pancreatic cancer in each group. The symptoms of diabetes and diarrhea were not relieved, but there was improvement of general condition in some patients. Stones re-occurred after surgery in one patient. Two patients with pancreatic duct dilation and cysts underwent endoscopic treatment（ n = 1 ） and surgical procedure（ n = 1 ） , respectively. But the latter patient experienced gastric bleeding, cirrhosis and jaundice with unknown reason after the surgery. Conclusion In adult patients with CP, endoscopic and surgical procedures had similar effect in patients with pancreatic duct stones and dilation. Surgical procedures are preferably performed in those with pancreatic occupying lesions. Further study is needed in those only with pancreatic duct dilation. The above treatments can improve general conditions in some patients. Intensive surveillance is suggested to the patients with painless CP.
出处
《中华消化内镜杂志》
北大核心
2009年第5期238-242,共5页
Chinese Journal of Digestive Endoscopy
关键词
胰腺炎
慢性
无痛性
胰胆管造影术
内窥镜逆行
外科
治疗效果
Pancreatitis, chronic
Painless
Cholangiopancreatography, endoscopic retrograde
Surgical procedures
Treatment effectiveness
