慢性胰腺炎138 例分析
| 作者: |
1罗桢,
2周戎君,
1高泰龙,
1欧政林,
1韩同,
1李宜雄
1 中南大学湘雅医院 胆道胰腺外科，湖南 长沙 410008 2 中南大学湘雅医院 乳腺科，湖南 长沙 410008 |
| 通讯: |
李宜雄
Email: liyixiong2011@hotmail.com |
| DOI: | 10.3978/.10.3978/j.issn.1005-6947.2015.03.014 |
摘要
目的：探讨慢性胰腺炎（CP）的发病因素及诊治特征。 方法：回顾性分析138 例CP 患者一般资料、临床表现、治疗方法，探讨主要危险因素与临床特征的关系， 根据2012 年中华医学会CP 诊治指南对进行患者临床分型、分期，用M-ANNHEIM 的评分系统分析患 者治疗（手术治疗与保守治疗）前后CP 病情变化。 结果：138 例CP 患者中，116 例（84.1%）以腹痛为主要表现；长期饮酒者44.2%（61/138），长期 吸烟42.8%（59/138）、高脂血症39.9%（55/138）、胆道疾病20.2%（28/138）；I 型11 例，II 型 58 例，III 型47 例，IV 型22 例；1 期69 例，2 期47 例，3 期22 例。大量饮酒患者胰腺钙化比例高于 非饮酒患者，而长期吸烟患者胰腺钙化比例与糖尿病比例均高于非吸烟患者（均P<0.05）。1 期患者 保守治疗与手术治疗效果差异无统计学意义（P=0.744），2 期患者手术治疗效果优于保守治疗（P<0.05）， 3 期患者保守治疗治疗效果优于手术治疗（P<0.05）。 结论：饮酒、吸烟、高脂血症、胆道疾病依然是CP 的主要致病危险因素，不同因素所致CP 的特征有 所不同，应该根据CP 诊治指南并结合患者具体情况，制定合理的治疗方案。
关键词：
胰腺炎，慢性/ 治疗
危险因素
饮酒
吸烟
Analysis of 138 cases of chronic pancreatitis
CorrespondingAuthor:LI Yixiong Email: liyixiong2011@hotmail.com
Abstract
Objective: To investigate the pathogenic factors, and diagnostic and treatment features of chronic pancreatitis (CP). Methods: The general data, clinical manifestations, therapeutic protocols, and relationship between major risk factors and clinical features in 138 CP patients were retrospectively analyzed. Clinical typing and staging of the patients were performed according to CP Diagnosis and Treatment Guideline of the Chinese Medical Association (2012), and changes of the disease state of the patients between pre- and post-treatment were analyzed based on M-ANNHEIM classification system. Results: Of the 138 patients, abdominal pain was the main symptom in 116 cases (84.1%); cases with regular alcohol consumption accounted for 44.2%, with smoking habit accounted for 42.8%, with hyperlipidemia accounted for 39.9%, and with biliary tract disease accounted for 20.2%, respectively; 11 cases were classified as clinical type I, 58 cases were type II, 47 cases were type III and 22 cases were type IV; 69 cases were at clinical stage I, 47 cases at stage II, and 22 cases at stage III. The proportion of cases with pancreatic calcification in patients with regular alcohol consumption was higher than that in non-alcohol consumers, while either the proportion of cases with pancreatic calcification or diabetes in patients with smoking habit were higher than those in patients who did not smoke (all P<0.05). There was no significant difference in therapeutic results between stage I patients undergoing conservative treatment and surgical treatment (P=0.744), while the therapeutic result of surgical treatment was better than that of conservative treatment in stage II patients, and conservative treatment was better than surgical treatment in stage III patients (both P<0.05). Conclusion: Alcohol consumption, smoking, hyperlipidemia and biliary tract disease are still the main risk factors for occurrence of CP, the features are somewhat different in CP caused by different factors, and choice of plan of treatment should be made on the basis of the Diagnosis and Treatment Guideline and the specific conditions of patients.
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