慢性胰腺炎的诊断和治疗:一篇综述
Vikesh K Singh1, Dhiraj Yadav2, Pramod K Garg3
1Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland.
JAMA
|December 21, 2019
概括
慢性胰腺炎是一种痛苦的胰腺疾病, 管理重点是改变生活方式,缓解疼痛,以及解决糖尿病和消化问题等并发症.
科学领域:
- 胃肠病学和肝病学
- 胰腺疾病
- 内部医学
背景情况:
- 慢性胰腺炎 (CP) 是一种常见的炎症性和纤维性胰腺疾病,每10万名成年人中有42-73人受到影响.
- 遗传 predispositions 和环境因素, 包括大量的酒精消费和吸烟, 都有助于CP的发病.
- 在许多患者中发现了SPINK1,CFTR或PRSS1基因的基因突变.
研究的目的:
- 审查慢性胰腺炎的原因,临床表现,诊断方法和治疗策略.
- 突出环境和遗传因素对CP发展的影响.
- 概述当前治疗方法来管理CP症状和长期后果.
主要方法:
- 对慢性胰腺炎病因,诊断和治疗的文献综述.
- 对肺结核发病率和风险因素的流行病学数据的分析.
- 关于CP管理的临床指南和研究结果的综合.
主要成果:
- 滥用酒精和吸烟是CP的重要环境风险因素.
- 基因突变 (SPINK1,CFTR,PRSS1) 涉及自发症和遗传性 CP 形式.
- 常见的症状包括慢性腹痛,长期糖尿病和外分泌功能不全的风险.
结论:
- 治疗胰腺癌需要多方面的方法,包括改变生活方式,治疗疼痛和治疗胰腺功能不全.
- 诊断成像 (CT,MRI,EUS) 对于识别胰腺和管道变化至关重要.
- 治疗策略包括戒酒和吸烟,止痛药,胰腺酶替代,在某些情况下,内镜或手术干预管道阻塞.
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