胰腺癌147例的诊断治疗分析  

The diagnosis and management of pancreatic carcinoma: a report of 147 cases

作　　者：郑树森[1] 粱廷波[1] 黄东胜[1] 俞军 徐骁[1] 朱伟芳[1] 

机构地区：[1]浙江医科大学附属第一医院肝胆胰外科,杭州310003

出　　处：《中华普通外科杂志》2000年第5期270-273,共4页Chinese Journal of General Surgery

摘　　要：目的　探讨分析胰腺癌的诊治经验和影响手术切除率的因素。方法　回顾分析我院1990年 1月至 1997年 12月收治的 147例胰腺癌的诊治情况 ,并结合临床表现、实验室结果、影像学检查等临床资料 ,对胰腺癌的可切除性和根治性进行评估。结果　 147例胰腺癌中胰头癌和胰体尾癌的切除率分别为 5 4% (5 4/99)、48% (13/2 7) ,根治率分别为 48% (47/99)、30 % (8/2 7) ;手术病死率为3%。无消瘦、TNM早期 ,影像学检查无血管浸润和 (或 )远处转移者具有较高的手术切除率 (P <0 0 5 )。病程长、有腹痛症状的手术切除率似有下降趋势。结论　胰腺癌的早期诊断和以手术为主的综合治疗是胰腺癌外科治疗的基础。评估胰腺癌可切除性指标包括有无消瘦、术前TNM分期、影像学检查等。Objective[WT5”BZ] To summarize the clinical experiences for the diagnosis, management and factors influencing the resection rate of pancreas carcinoma.[WT5”HZ] Method[WT5”BZ] The data including clinical manifestations, lab findings, imaging results in 147 cases with pancreas carcinoma were reviewed retrospectively.The resectability and radical resectability in these patients were assessed.[WT5”HZ] Results[WT5”BZ] The overall resection rate and the radical resection rate were 53 2%(67/126) and 43 7%(55/126) respectively. The resection rate for pancreas carcinoma in head, body and tail was 54 5%(54/99) and 48 1%(13/27) respectively and the radical resection rate was 47 5%(47/99), and 29 6%(8/27) respectively. The total operative mortality rate was 3 3%. Those patients with short history,at early stage of TNM, without marasmus, vessel invasion and/or distant metastasis had higher resection rate ( P <0 05) while the resection rate of those patients with abdominal pain or long history tends to decrease.[WT5”HZ]Conclusions[WT5”BZ] The early diagnosis and comprehensive surgical treatment remain as the mainstay for the management of patients with pancreas carcinoma.The history, preoperative TNM stage, clinical manifestation (marasmus, abdominal pain), imaging findings are all factors relevant to the resectability of the cancer. [WT5”HZ]

关 键 词：胰腺肿瘤 诊断 手术切除术 影响因素 

分 类 号：R735.9[医药卫生—肿瘤]