【摘要】：目的:總結(jié)始發(fā)癥狀為急性胰腺炎(AP)的胰腺占位性病變的臨床特點(diǎn),以期為今后該類情況的診治提供借鑒。方法:收集內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院于2010年9月—2014年10月收治的12例典型上述病例資料,對其臨床表現(xiàn)、實(shí)驗(yàn)室指標(biāo)、影像學(xué)特點(diǎn)等多項(xiàng)參數(shù)進(jìn)行綜合分析。結(jié)果:12例患者均診斷為AP入院;男女性別比列為11:1,明顯高于胰腺癌發(fā)病的性別比(1.4:1);12例(100%)尿淀粉酶均顯著增高(1500IU/L),伴明顯腰部放射痛8例(66.7%),CA19-9升高6例(50.0%);膽紅素增高6例(50.0%),胰管擴(kuò)張7例(58.3%);5例獲根治性手術(shù),其余因失去根治手術(shù)機(jī)會行非手術(shù)或姑息手術(shù)治療,其中1例(8.3%)姑息手術(shù)術(shù)后病理確診慢性胰腺炎。結(jié)論:在AP患者中,男性患者、尿淀粉酶持續(xù)增高、伴有腰部放射痛、輕度胰管擴(kuò)張、黃疸持續(xù)不退等對胰腺占位病變的診斷有提示作用。
[Abstract]:Objective: to summarize the clinical features of pancreatic occupying lesions with primary symptom of acute pancreatitis (AP) in order to provide reference for the diagnosis and treatment of acute pancreatitis. Methods: the data of 12 typical cases from September 2010 to October 2014 in affiliated Hospital of Inner Mongolia Medical University were collected, and the clinical manifestations, laboratory indexes and imaging features were analyzed. Results: all the 12 patients were diagnosed as AP. The ratio of male to female was 11: 1, which was significantly higher than that of pancreatic cancer (1.4: 1), 12 cases (100%) were significantly higher in urine amylase (1500IU/L), 8 cases (66.7%) were accompanied with obvious loin radiodynia, 6 cases (50.0%) were elevated CA19-9, 6 cases (50.0%) were bilirubin, 7 cases (58.3%) were dilatation of pancreatic duct, 5 cases received radical operation. The other patients were treated with non-operative or palliative operation because of the loss of radical operation. One case (8.3%) with chronic pancreatitis was diagnosed by pathology after palliative operation. Conclusion: in male patients with AP, the continuous increase of urine amylase, radiodynia in the waist, mild dilatation of pancreatic duct and persistent jaundice are helpful in the diagnosis of pancreatic space occupying lesions.
【作者單位】： 內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院普通外科;
【基金】：內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院重大科研資助項(xiàng)目(NYFYYB2014015)
【分類號】：R657.5
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本文編號：2282326