摘要
目的:回顾性分析9 a间慢性胰腺炎(CP)的临床特点．方法:对住院诊断CP 213例,按发病情况、临床表现、诊断方法及漏误诊等特点进行统计．结果:CP213例,占消化科住院患者的4．38％, 男女之比1:0．84,9 a间每3 a发病增长为 38．6％,病因:胆源性36．2％,酒精性42．7％,高血脂13．6％,原因不明7．5％;临床表现:持续腹痛仅9．9％,进食后腹痛44％,两者相加为 53．5％,而慢性腹泻或脂肪泻占57％,进高脂肪餐(包括饮酒)后腹胀或腹泻81％,吸收不良 41％,糖尿病7．0％;在诊断方面:72．3％是以临床表现、大便脂肪定性或胰腺外分泌功能试验及CT、EUS影象学特征诊断,27．7％超声内镜引导下细针穿插通过病理诊断,在漏误诊方面:33．8％长期诊断为慢性胃炎或萎缩性胃炎,30．5％诊断为慢性腹泻、肠炎或慢性结肠炎,11．3％诊断为胆系结石或胆囊术后综合症, 3．8％诊断为胰腺新生物或胰腺癌．结论:CP发病率在上升,临床表现腹痛不突出,而且多样性,应早期诊断。
AIM： To conclude the clinical characteristics of 213 chronic pancreatitis （CP） patients during the past 9 years.
METHODS： The data of pathogenesis, clinical manifestations, diagnosis and missed diagnosis were retrospectively analyzed in 213 CP patients admitted in the past 9 years.
RESULTS： CP patients covered a percentage of 4.38% in department of digestive diseases, and the ratio of male to female was I ： 0.84. The rate of increment every 3 years in the past 9 years was 38.6%. Of 213 cases, the rates were 36.2%, 42.7%, and 13.6% for biliary pancreatitis, alcoholic pancreatitis, and high levels of blood lipid, respectively, and the pathogenesis for 7.5% of 213 was not clear. 9.9% of 213 patients suffered a continual abdominal pain, 44% with abdominal pain after taking food, and 53.5% had the preceding two symptoms. Besides, chronic diarrhea or steatorrhea appeared in 57% patients, abdominal distension or diarrhea in 81% patients after intake of high-fat diet （including alcohol）, malabsorption in 41% patients, and diabetes in 7.0% patients. Of all the patients, 72.3% were diagnosed with clinical manifestations, fatty stool or pancreatitic exocrine function test, computed tomography, and endoscopic ultrasonography, and 27.7% were diagnosed with endoscopic ultrasound guided fine needle aspiration biopsy. Of 213 patients, 33.8% were misdiagnosed with chronic gastritis or atrophic gastritis, 30.5% with chronic diarrhea, enteritis or chronic colitis, 11.3 Yo with biliary stones or postcholecystestomy syndrome, and 3.8% with pancreatic neoplasm or cancer.
CONCLUSION： The incidence rate of CP is rising, and its manifestation of abdominal pain is not significant, but of variety. Early diagnosis is important.
出处
《世界华人消化杂志》
CAS
北大核心
2006年第14期1430-1432,共3页
World Chinese Journal of Digestology
关键词
临床特点
慢性胰腺炎
误诊
Clinical characteristics
Chronic pan-creatitis
Misdiagnosis
