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目的:探讨胰腺囊性肿瘤临床特点、诊断方式以及治疗结局,为临床诊治提供参考。方法:回顾性分析2007年9月—2014年9月112例胰腺囊性肿瘤患者的临床资料。结果:112例患者中,111例(99.1%)胰腺囊性肿瘤单发;确诊时81例(72.32%)患者无明显临床症状;超声、CT、MRI、EUS诊断的准确率分别为86.61%、89.11%、93.88%、93.33%,4种检查方式准确率差异无统计学意义(χ2=1.010,P=0.224);胰体尾加脾切除术48例(42.86%),胰十二指肠切除术23例(20.54%),保留脾脏胰体尾切除13例(11.61%),Beger术3例(2.68%),全胰腺切除2例(1.78%),胰腺中段切除1例(0.89%),联合脏器切除1例(0.89%),肿瘤摘除21例(18.75%);术后发生胰瘘18例(16.07%),其中胰十二指肠切除术后胰瘘发生7例(30.43%,7/23),胰体尾加脾切除胰瘘发生9例(18.75%,9/48),保留脾脏胰体尾切除术后胰瘘发生2例(15.38%,2/13),胰十二指肠切除术后胰瘘发生率明显高于其他两种术式(χ2=4.767,P=0.010;χ2=5.854,P=0.007);76例(67.86%)病理结果良性,36例(32.14%)病理结果恶性。良性患者5年生存率为100%,恶性患者1、3、5年生存率分别为86.96%、52.17%、26.08%。结论:胰腺囊性肿瘤多数患者无明显临床症状,单发胰体尾部胰腺肿瘤占多数,影像学诊断准确率较高,良性胰腺囊性肿瘤预后好,恶性胰腺囊性肿瘤应积极实施根治手术。
Objective: To investigate the clinical features, diagnosis and treatment outcome of pancreatic cystic neoplasm and provide reference for clinical diagnosis and treatment. Methods: The clinical data of 112 patients with pancreatic cystic tumors from September 2007 to September 2014 were retrospectively analyzed. Results: Among the 112 patients, 111 cases (99.1%) had single pancreatic cystic tumor; 81 cases (72.32%) were diagnosed without obvious clinical symptoms; the diagnostic accuracy of ultrasound, CT, MRI and EUS were 86.61% 89.11%, 93.88% and 93.33% respectively. There was no significant difference in the accuracy of the 4 examinations (χ2 = 1.010, P = 0.224); 48 cases (42.86%) had pancreatic body tail plus splenectomy, pancreatoduodenectomy There were 23 cases (20.54%) in operation, 13 cases (11.61%) in pancreatic body tail resection, 3 cases in Beger surgery (2.68%), 2 cases in total pancreatectomy (1.78% One case (0.89%) and 21 cases (18.75%) of resected organ showed pancreatic fistula after surgery, 18 cases (16.07%) had pancreatic fistula after operation, pancreatic fistula occurred after pancreatoduodenectomy in 7 cases (30.43% There were 9 cases (18.75%, 9/48) in pancreatic body plus spleen resection and pancreatic fistula in 2 cases (15.38%, 2/13) The incidence of pancreatic fistula after nodal resection was significantly higher than that of the other two operations (χ2 = 4.767, P = 0.010; χ2 = 5.854, P = 0.007); 76 cases (67.86% Pathological results were malignant. The 5-year survival rate of benign patients is 100%. The 1, 3, 5-year survival rates of malignant patients are 86.96%, 52.17% and 26.08%, respectively. Conclusions: Most patients with pancreatic cystic tumors have no obvious clinical symptoms. The pancreatic tumors of single pancreatic body and tail are the majority, and the accuracy of imaging diagnosis is high. The prognosis of benign pancreatic cystadenoma is good. Malignant pancreatic cystadenoma should be actively undergone radical surgery.