胰腺癌合并急性胰腺炎和单纯急性胰腺炎诊断分析

发布时间：2018-03-28 13:57

本文选题：急性胰腺炎　切入点：胰腺癌　出处：《中国实用内科杂志》2017年02期

【摘要】：目的旨在提高对胰腺癌(PC)合并急性胰腺炎(AP)患者的认识,减少PC的漏诊率。方法回顾性分析北京协和医院19例AP合并PC患者的临床资料,并与27例AP的临床表现及辅助检查对比。结果 (1)AP合并PC与单纯AP患者临床症状相比,后者的恶心呕吐、腹痛、腹胀的发生率明显升高(P0.05),发热情况差异无统计学意义(P0.05);(2)实验室检查两组比较,后者白细胞、胰淀粉酶及脂肪酶、血糖明显升高(P0.05),而丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、直接胆红素(DBIL)、总胆固醇(TC)、三酰甘油(TG)等差异均无统计学意义(P0.05);(3)影像学两组比较,前者较后者更易出现胰管不规则扩张(P0.05)。结论对AP合并PC患者需结合病史及辅助检查全面评估,AP合并PC患者临床症状和实验室检查表现更轻,借助影像学可以及早识别。
[Abstract]:Objective to improve the understanding of patients with pancreatic carcinoma (PC) complicated with acute pancreatitis (AP) and to reduce the rate of missed diagnosis of PC. Methods the clinical data of 19 cases of AP with PC in Peking Union Hospital were analyzed retrospectively. Results compared with the clinical symptoms of simple AP patients, the patients with AP had nausea, vomiting and abdominal pain. The incidence of abdominal distention was significantly higher than that of P0.05A, and there was no significant difference in fever between the two groups. There was no significant difference between the two groups in the imaging of alanine aminotransferase (alt), total bilirubin (TBILL), direct bilirubin (Dbilirubin), total cholesterol (TCU), triacylglycerol (TG3). Conclusion the clinical symptoms and laboratory findings of patients with AP complicated with PC should be comprehensively evaluated in combination with history and auxiliary examination, and the clinical symptoms and laboratory findings of patients with AP complicated with PC can be identified as early as possible by means of imaging. The former is more likely than the latter to develop irregular dilatation of the pancreatic duct (P0.05).
【作者单位】：中国医学科学院北京协和医学院北京协和医院消化内科;
【基金】：国家自然科学基金(81072055) 国家教育部新教师基金资助(20101106120059)
【分类号】：R735.9;R576

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