论文部分内容阅读
目的:探讨胰腺癌早期诊断和提高手术疗效的临床措施。方法:回顾性分析我院自1974年-2001年间连续收治的340例胰腺癌的诊断及外科治疗。结果:本组19.1%(65/340)的胰腺癌病例施行了根治性手术,手术死亡率7.7%(5/65),80.9%(275/340)行姑息性手术及探查术。行根治性手术的胰腺癌病例,首发症状多为上腹部隐痛、胀满不适、纳差、乏力和消瘦等非特异性症状,仅16.9%为无痛性黄疸。影像学检查间接征象检出率分别为胆道扩张97.1%,胆囊肿大88.8%,胰管狭窄、中断、移位和增粗93.8%。对有首发症状的高危人群,联用影像学技术检查直接及间接征象,并及早手术探查,有助于胰腺癌早期诊断。Child改良式胰十二指肠切除术后并发症和手术死亡率明显降低。结论:联用影像技术、及早手术探查,早识别,早诊断,早治疗,是提高胰腺癌早期诊断改善疗效的有效措施。根治性手术切除(Child改良术式)为主的综合性治疗仍是治疗本病的主要治疗措施。
Objective: To investigate the early diagnosis of pancreatic cancer and improve the clinical efficacy of surgery. Methods: A retrospective analysis of our hospital from 1974 to 2001 consecutive cases of pancreatic cancer diagnosis and surgical treatment of 340 cases. Results: In this group, 19.1% (65/340) of pancreatic cancer patients underwent radical surgery. The operative mortality rate was 7.7% (5/65) and 80.9% (275/340) in palliative surgery and exploration. Radical surgery in patients with pancreatic cancer, the first symptom are mostly abdominal pain, swelling, discomfort, anorexia, fatigue and weight loss and other non-specific symptoms, only 16.9% of painless jaundice. The indirect detection rate of imaging examination was 97.1% for biliary tract enlargement, 88.8% for gallbladder enlargement, 93.8% for pancreatic duct stenosis, interruption, shift and thickening. For first-line symptoms of high-risk groups, combined with imaging techniques to detect direct and indirect signs, and early surgical exploration, contribute to the early diagnosis of pancreatic cancer. Child modified pancreatoduodenectomy postoperative complications and mortality was significantly reduced. Conclusion: Combined imaging technique, early surgical exploration, early identification, early diagnosis and early treatment are effective measures to improve the early diagnosis and treatment of pancreatic cancer. Radical surgical resection (Child modified surgical) -based comprehensive treatment is still the main treatment for the treatment of this disease.