急性酒精性胰腺炎不能完全康复。

E Małecka-Panas, A Juszyński, E Wilamski
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摘要

该研究的目的是通过临床检查、功能检查和影像学技术来确定急性酒精性胰腺炎(a.a.p)的晚期预后。47例患者在中度临床病程后4-7年接受胰腺分泌素-核蛋白试验(SCT)、葡萄糖耐量试验(GTT)、超声(US)和计算机断层扫描(CT)检查。外分泌胰腺功能障碍患者占63.8%,糖耐量受损患者占12.8%,明显糖尿病患者占17.0%。GIT和显性糖尿病仅在需要补充酶的严重外分泌功能障碍患者中发现。超声表现为胰腺结构异常,以胰腺增大、假性囊肿、结构不均一、轮廓不规则、Wirsung管扩张、钙化为主(36.21%),ct表现为44.7%。在SCT, US和CT中发现的伴有病理的16例患者中,14例(29.8%)出现腹痛发作。我们的结论是,根据临床症状、外胰和内分泌胰功能检查和影像学技术的反映,在大约三分之一的患者中,即使是中度发作的a.a.p也可能导致慢性胰腺炎。我们建议急性酒精性胰腺炎患者应进行前瞻性评估,包括功能和结构评估,以便早期识别和治疗所显示的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute alcoholic pancreatitis does not lead to complete recovery.

The aim of the study was to determine the late outcome of acute alcoholic pancreatitis (a.a.p.), as assessed by clinical examination, functional tests and imaging techniques. 47 patients, 4-7 years after a.a.p. of moderate clinical course underwent a secretin-cerulein test (SCT), glucose tolerance test (GTT), ultrasound (US) and computed tomography (CT) of the pancreas. Exocrine pancreatic function impairment was found in 63.8%, glucose impaired tolerance (GIT)-in 12.8% overt diabetes-in 17.0%. GIT and overt diabetes were found only in patients with severe exocrine function impairment requiring enzyme supplementation. Ultrasound revealed pancreatic structure abnormalities mostly pancreas enlargement, pseudocysts, structural heterogeneity, contour irregularity, Wirsung duct dilatation and calcifications in 36.21% patients and computed tomography in 44.7%. Out of 16 patients with concomittant pathology found in SCT, US and CT 14 (29.8%) suffered from attacks of abdominal pain. We conclude that, as reflected by clinical symptoms, exo- and endocrine pancreatic function tests and imaging techniques, in about one third of patients even a moderate attack of a.a.p may lead to chronic pancreatitis. We suggest that patients after acute alcoholic pancreatitis should undergo prospective evaluation including both the function and structure estimation in order to early recognize and treat the revealed changes.

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