慢性胰腺炎诊治再总结

目的进一步总结我院慢性胰腺炎的诊治经验，提高本病的诊治水平。方法回顾性分析我院2001年11月至2005年4月间收治的129例慢性胰腺炎病人的临床资料。结果本组129例慢性胰腺炎病人，发病1年内确诊率42．6％，5年内确诊率可达82．2％；长期饮酒导致慢性胰腺炎者占38．8％，胆源性者占27．9％；B超、CT和磁共振（MRI／MRCP）检查阳性率分别为68．3％、80．6％和82．0％，ERCP检查阳性率为46．3％；尿对氨基苯甲酸（PABA）试验阳性率为71．6％；74例接受了手术治疗，术后94．6％疼痛明显减轻，而术后并发症发生率为9．5％。结论慢性胰腺炎的病因特点有所变化，长期饮酒致病的比例增高；尽早明确诊断，去除诱因，口服止痛药物及胰酶制剂，适时选择适当的介入或手术治疗，有利于减轻慢性胰腺炎病人的症状，延缓病变进展。

Re-summarization of diagnosis and treatment of chronic pancreatitis

Objective To re-evaluate the diagnosis and treatment of chronic pancreatitis (CP). Methods The clinical data of 129 patients with CP treated in our hospital from November 2001 to April 2005 were retrospectively analyzed. Results The 1- and 5-year rates of confirmed diagnosis of CP were 42. 6% and 82. 2%, respectively. The CP was caused by long-term alcohol drinking in 38. 8% of all the patients and by biliary reasons in 27. 9%. The positive rate for diagnosis of CP was 68. 3% by B-US, 80. 6% by CT, 82. 0% by MRI/MRCP, 46. 3% by ERCP and 71. 6% by PABA. Seventy-four patients (57. 4%) received surgical treatment and 94. 6% of them felt less pain and 9. 5% (7 patients) had postoperative complications.Conclusions There is a dramatic change in the etiology of CP, i. e. the occurring rate of CP due to chronic alcohol consumption is increasing. Early diagnosis, eradication of stimulating pathogenic factors, oral analgesics and pancreatic enzymes and appropriate selection of endoscopic or surgical treatment can effectively eliminate symptoms of CP and postpone its development.