63例胰腺癌临床诊治分析

目的探讨胰腺癌早期诊断方法,减少误诊误治率。方法回顾分析63例胰腺癌临床诊治资料。结果63例胰腺癌中49例有误诊史,误诊率高达78%,多数误诊为胃炎、胃溃疡、胆囊炎及肝炎,仅14例初诊明确诊断。63例中外科根治性手术14例,剖腹探查、姑息性手术24例,经门诊筛查不能手术的25例内科化疗或介入治疗。3种疗法治疗后平均生存时间为:18个月、9个月、10个月。结论胰腺癌早期诊断率低,手术切除率低,B型超声显像及CT检查是诊断胰腺癌理想的无创伤检查方法,可在术前精确判断肿瘤能否被切除,减少误诊误治率。

Clinical Diagnosis and Treatment of 63 Cases with Pancreatic Cancer

Objective To explore the early diagnosis of pancreatic cancer and the methods of reducing misdiagnosis and mistreatment.Methods The clinical data of 63 patients with pancreatic cancer including diagnosis and treatment were analyzed retrospectively.Results 49 cases had ever been misdiagnosed. The misdiagnosis rate has highly reached 78%. Most of these cases were misdiagnosed for gastritis,gastric ulcer,cholecystitis and hepatitis. Only 14 cases were correctly diagnosed in the first time. In 14 of the resected patients,radical resection was performed. 24 patients were performed by exploratory laparotomy and palliative operation. 25 patients who could not undergo an operation through the screening of policlinic finally received medical chemotherapy or intervention.Comparing with the three treatments,the average survival time were 18 months,9 months and 10 months. Conclusions The early diagnosis rate of pancreatic cancer is low,also the resection rate. The staging by BUS and CT are the perfect nontraumatic methods of examination. They are the best evaluation methods of carcinoma staging before the operation and reducing misdiagnosis rate.