超声内镜对胰腺假性囊肿的预后评估作用

发布时间：2018-04-20 23:31

本文选题：胰腺假性囊肿 + 超声内镜　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的探讨超声内镜对胰腺假性囊肿的预后评估作用,及其预后影响因素。方法回顾性分析2014年1月至2016年10月广西医科大学第一附属医院行保守治疗的42例(共48个假性囊肿,其中6例多发假性囊肿患者拆分为12个假性囊肿)胰腺假性囊肿患者的临床资料、假性囊肿的超声内镜检查结果、预后,并进行随访。根据患者随访结果,将患者分为治愈组,未治愈组。对两组的临床资料、假性囊肿的超声内镜结果进行统计学处理,分析。结果:1.胰腺假性囊肿小于等于6cm者33例,缓解者10例,大于6cm者15例,缓解3例,差别无统计学意义(P0.05)。2.并发于急性胰腺的假性囊肿为22例,缓解8例,并发于慢性胰腺炎的假性囊肿为20例,缓解0例,差别有统计学意义(P=0.004)。3.胰腺假性囊肿为单个者27例,缓解6例,假性囊肿为多个者15例,缓解2例,差别无统计学意义(P0.05)。4.胰腺假性囊肿位于胰头部者10例,缓解者3例,位于体尾部者38例,缓解10例,差别无统计学意义(P0.05)。5.胰腺假性囊肿内部存在分隔者11例,缓解者0例,无分隔者37例,缓解13例,差别有统计学意义(P=0.023)。6.胰腺假性囊肿内部有固体内容物者20例,缓解0例,无固体内容物者28例,缓解13例,差别有统计学意义(P=0)。7.胰腺假性囊肿胰管含有胰石者7例,缓解0例,胰管无胰石者35例,缓解8例,差别无统计学意义(P0.05)。8.胰腺假性囊肿胰管扩张者9例,缓解0例,胰管无扩张者33例,缓解8例,差别无统计学意义(P0.05)。结论:1.超声内镜能清晰显示胰腺假性囊肿的许多特征,因此对评估临床预后有重要的及独特价值。2.胰腺假性囊肿的预后与多种因素相关,并发于急性胰腺炎的假性囊肿、假性囊肿内无分隔、假性囊肿内无固体内容物者更容易自然缓解。3.并发于慢性胰腺炎的假性囊肿、胰管存在扩张、胰管存在胰石、假性囊肿内有分隔、假性囊肿内有固体内容物者,自然缓解率较低,建议有症状时及时手术或内镜干预处理。
[Abstract]:Objective to evaluate the prognostic value of endoscopic ultrasonography in pancreatic pseudocyst and its prognostic factors. Methods from January 2014 to October 2016, 42 patients (48 pseudocysts) who received conservative treatment in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Six patients with multiple pseudocysts were divided into 12 pseudocysts. The clinical data of pancreatic pseudocysts, the results of endoscopic ultrasonography and the prognosis of pseudocysts were followed up. According to the results of follow-up, the patients were divided into the cured group and the uncured group. The clinical data and endoscopic results of pseudocyst were statistically analyzed. The result is 1: 1. There were 33 cases of pancreatic pseudocyst less than or equal to 6cm, 10 cases of remission, 15 cases of greater than 6cm, and 3 cases of remission. There were 22 cases of pseudocyst complicated with acute pancreas, 8 cases of remission, 20 cases of pseudocyst complicated with chronic pancreatitis, and 0 cases of remission. The difference was statistically significant. There were 27 cases of pancreatic pseudocyst, 6 cases of remission, 15 cases of pseudocyst and 2 cases of remission. There were 10 cases of pancreatic pseudocyst located in the head of pancreas, 3 cases of remission, 38 cases of body and tail, and 10 cases of remission. There were 11 cases of pancreatic pseudocyst, 0 cases of remission, 37 cases of no septum and 13 cases of remission. The difference was statistically significant (P < 0. 023. 6). There were 20 cases of solid content in pancreatic pseudocyst, 0 case of remission, 28 cases of no solid content and 13 cases of remission. The difference was statistically significant. Pancreatic pseudocyst contained pancreatic stone in 7 cases, remission in 0 cases, pancreatic duct without pancreatic stone in 35 cases, remission in 8 cases. There were 9 cases of pancreatic duct dilatation, 0 cases of remission, 33 cases of no dilatation of pancreatic duct and 8 cases of remission of pancreatic pseudocyst. The difference was not statistically significant (P 0.05). Conclusion 1. Ultrasound endoscopy can clearly display many characteristics of pancreatic pseudocyst, so it has important and unique value in evaluating clinical prognosis. The prognosis of pancreatic pseudocyst is related to many factors. Pseudocyst complicated with chronic pancreatitis, pancreatic duct dilatation, pancreatic stone, pseudocyst, solid content in pseudocyst, natural remission rate is low.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R576

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