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[慢性胰腺炎手术的长期随访结果]

[Long-term follow-up results of surgery for chronic pancreatitis].

作者信息

Oláh A, Pardavi G, Belágyi T, Wellner I, Nagy S A

机构信息

Petz Aladár Megyei Kórház, Sebészeti Osztály.

出版信息

Magy Seb. 2000 Feb;53(1):13-6.

Abstract

Authors evaluate the late results of 51 operated patients by decompression or resection procedure for chronic pancreatitis between 1990-94, based on a follow-up period of 86 months. Only 34% of the 47 investigated patients could be classified as "good" results group--it is the half part of the good results of their former study based on 20 months follow-up period. The incidence of late deaths was very high--27.6%. Eighty-five percent of all the lost patients (11 pts) died after the seventh postoperative year. The most threatened group seems to be the alcoholic and insulin-dependent diabetic patients. This combination was the cause of death in third part of the cases. IDDM developed altogether in 9 patients, on average 3.7 years after the operation, namely it was the consequence of the irreversible progressive natural history of disease. The rate of disability is 44%, and it is significantly higher in the resected group than after decompression, just like the late mortality rat. Based on their results authors emphasise that in chronic pancreatitis the short-term (20-36 months) follow-up results may be deceptive, real outcome of the surgical treatment could be expected only after 5 years postoperatively.

摘要

作者评估了1990年至1994年间因慢性胰腺炎接受减压或切除手术的51例患者的远期结果,随访期为86个月。在47例接受调查的患者中,只有34%可归类为“良好”结果组,这是他们之前基于20个月随访期研究中良好结果的一半。晚期死亡率非常高,为27.6%。所有失访患者(11例)中有85%在术后第七年之后死亡。受威胁最大的群体似乎是酗酒和胰岛素依赖型糖尿病患者。这种组合是三分之一病例的死亡原因。共有9例患者发生了胰岛素依赖型糖尿病,平均在术后3.7年,也就是说这是疾病不可逆进展自然史的结果。残疾率为44%,切除组明显高于减压组,晚期死亡率也是如此。基于他们的结果,作者强调在慢性胰腺炎中,短期(20至36个月)随访结果可能具有欺骗性,手术治疗的实际结果只能在术后5年才能预期。

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