胰管结石32例临床分析
发布时间：2019-06-24 10:15
【摘要】：背景胰管结石(pancreatic duct stone, PDS)为一种发病率较低的疾病,自1667年DeGraaf首先描述此病后,大量学者对其病因、发病机制、临床表现、诊断方案、治疗方案、预后及其转归进行了进一步深入的研究。随着近年来影像诊断学的飞速发展,特别是MRCP、ERCP、CT的出现,此病检出率逐年上升。虽然本病的发病率很低,但可加重慢性胰腺炎,增加对胰腺组织的不可逆损害,甚至可诱发胰腺癌的发生,因此对胰管结石的诊断与治疗逐渐受到大家的重视。目的总结胰管结石的临床特点及治疗经验,提高胰管结石的临床诊断与治疗水平。方法对新乡医学院第一附属医院2001年至2013年间收治的32例经手术治疗或内镜治疗的胰管结石患者的临床资料进行回顾分析,获取患者年龄、性别、病程、主要临床症状、手术及内镜治疗方式、住院时间、预后及随访等基本信息,根据治疗方式不同分为手术组和内镜组。对所得数据采用SPSS 19.0统计学软件进行统计分析,比较手术组和内镜组临床疗效,组间对比采用t检验,率的比较采用χ2检验。结果32例患者中男性25例,女性7例,男女比例3.6：1,平均年龄39.47(23-67岁)。32例患者均伴有腹痛,且均号慢性胰腺炎合并存在,其中24例(75%)伴腰背部放射痛,2例(6.25%)伴有绞痛及剧痛；9例(28.12%)伴有腹泻；15例(46.88%)伴有体重减轻；4例(12.5%)伴有糖尿病；1例(3.13%)伴有黄疸；3例(9.4%)伴有发热。32例患者实验室检查中,4例(12.5%)伴有空腹血糖及尿糖升高；9例(28.12%)伴有血淀粉酶升高；8例(25%)伴有尿淀粉酶升高；1例(3.13%)伴血清胆红素升高,余实验室检查均为阴性。术前行B超、CT、ERCP和MRCP检查阳性率分别为86.7%、93.3%、85.7%和100%。32例均行外科手术或内镜治疗,其中手术治疗组20例,内镜治疗组12例。手术组和内镜组在住院时间方面差异有统计学意(P0.05),内镜组住院时间较手术组住院时间短；在年龄、病程、随访时间方面两组之间无统计学意义(P0.05)；在腹痛缓解方面两组间差异有统计学意义(P0.05),手术组优于内镜组；在腹泻、体重减轻、糖尿病方面两组间差异无统计学意义(P0.05)。术后平均随访39个月(2-60个月)；术后腹痛部分缓解7例,完全缓解23例；手术组20例未见结石复发,内镜组2例分别于术后12个月、20个月发现结石复发,均再次行内镜取石,至随访结束时未见复发。死亡2例,外科手术组1例于术后3个月死于急性心肌梗塞,内镜组1例于术后15个月死于胰腺癌。结论胰管结石的诊断以MRCP无创检查为首选方法；根据胰管结石的临床分型选择个体化治疗方式可取得可靠的疗效；内镜治疗也可作为胰管结石的治疗方法之一。
[Abstract]:Background Pancreatic duct stone (pancreatic duct stone, PDS) is a disease with low incidence. Since DeGraaf first described the disease in 1667, a large number of scholars have further studied its etiology, pathogenesis, clinical manifestations, diagnosis, treatment, prognosis and prognosis. With the rapid development of imaging diagnostics in recent years, especially the emergence of MRCP,ERCP,CT, the detection rate of this disease is increasing year by year. Although the incidence of this disease is very low, it can aggravate chronic pancreatitis, increase the irreversible damage to pancreatic tissue, and even induce the occurrence of pancreatic cancer. Therefore, the diagnosis and treatment of pancreatic duct stones have been paid more and more attention. Objective to summarize the clinical characteristics and treatment experience of pancreatic duct stones, and to improve the clinical diagnosis and treatment of pancreatic duct stones. Methods the clinical data of 32 patients with pancreatic duct stones treated by operation or endoscopy in the first affiliated Hospital of Xinxiang Medical College from 2001 to 2013 were analyzed retrospectively. the basic information such as age, sex, course of disease, main clinical symptoms, surgical and endoscopic treatment, hospitalization time, prognosis and follow-up were obtained. The data were statistically analyzed by SPSS 19.0 statistical software. The clinical efficacy of the operation group was compared with that of the endoscopic group. T test was used to compare the data between the two groups, and the rate was compared by 蠂 2 test. Results there were 25 males and 7 females, with an average age of 39.47 (23 鈮，
本文编号：2504985
[Abstract]:Background Pancreatic duct stone (pancreatic duct stone, PDS) is a disease with low incidence. Since DeGraaf first described the disease in 1667, a large number of scholars have further studied its etiology, pathogenesis, clinical manifestations, diagnosis, treatment, prognosis and prognosis. With the rapid development of imaging diagnostics in recent years, especially the emergence of MRCP,ERCP,CT, the detection rate of this disease is increasing year by year. Although the incidence of this disease is very low, it can aggravate chronic pancreatitis, increase the irreversible damage to pancreatic tissue, and even induce the occurrence of pancreatic cancer. Therefore, the diagnosis and treatment of pancreatic duct stones have been paid more and more attention. Objective to summarize the clinical characteristics and treatment experience of pancreatic duct stones, and to improve the clinical diagnosis and treatment of pancreatic duct stones. Methods the clinical data of 32 patients with pancreatic duct stones treated by operation or endoscopy in the first affiliated Hospital of Xinxiang Medical College from 2001 to 2013 were analyzed retrospectively. the basic information such as age, sex, course of disease, main clinical symptoms, surgical and endoscopic treatment, hospitalization time, prognosis and follow-up were obtained. The data were statistically analyzed by SPSS 19.0 statistical software. The clinical efficacy of the operation group was compared with that of the endoscopic group. T test was used to compare the data between the two groups, and the rate was compared by 蠂 2 test. Results there were 25 males and 7 females, with an average age of 39.47 (23 鈮，
本文编号：2504985
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