【摘要】 近年胰腺癌的发病率逐渐增加,但其早期诊断仍不满意。本文对确诊的37例胰头癌(CHP),29例胰体尾癌(CPBT)与急性黄疸性病毒性肝炎(IVH)和出现黄疸的胆石症(GS)各50例临床特点进行了对比研究。胰腺癌在男女两性发病率的比率为2.88:1.0。按时间早晚的顺序,CHP的早期症状出现率为食欲不振、上腹及右上象限疼痛、腹胀及腰痛;而黄疸作为最早期症状仅为8％。CPBT患者,剑下及左上象限腹痛以及体重迅速减少为其早期症状。实验室检查发现,CHP,CPBT,GS及IVH的血清总胆红素(STB)分别平均为11.5,0.74,4.4及4.9mg/dl。在上述三种黄疸性疾患,连续观察STB及SGPT的动态变化发现,GS和IVH的此两种指标基本上是同时下降;反之,CHP患者其STB逐渐上升,而SGPT逐渐下降,形成了酶-胆交叉现象,此种现象多出现于黄疸发生后15～20天。此种所见对CHP的诊断,以及CHP与GS和IVH间的鉴别诊断具有一定价值。本文对CT及ERCP作了重新估价。更多还原

【Abstract】 The incidence of pancreatic cancer is gradually increased in recent years, but the early diagnosis is still unsatisfactory. In this paper, a comparative study of the clinical criteria in 37 cases of cancer of the head of pancreas(CHP),29 cases of cancer of pancreatic body and tail (CP-BT), 50 cases of acute icteric viral hepatitis(IVH)and gall stone with jaundice(GS) either was made. The ratio of pancreatic cancer in males and females was 2.88:1.0. Chronologically, the frequencies of the early symptoms in CHP were anorexia, pain in epigastrium and RUQ, flatulence and backache; jaundice as an early symptom was only 8%, In CPBT, abdominal pain below the xyphoid and in LUQ, and rapid loss of weight were the chief early symptoms. Laboratory work disclosed that the av. levels of serum total bilirubin(STB) were 11.5, 0.74, 4.4, and 4.9 mg/dl in CHP, CPBT, GS, and IVH respectively. Consecutive study of STB and SGPT in the three icteric diseases showed that the levels of STB and SGPT were nearly decreased simultaneously in GS and IVH; but conversely, in CHP the STB increased step by step, and SGPT lowered gradually which formed a crossing sign usually appeared in 15-20 th days after admission. This finding may be of value both for the diagnosis of CHP, and the differential diagnosis between CHP and GS as well as IVH. The clinical signifance of CT and ERCP was re-evaluated.更多还原