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Construction and Application Research of Chinese Pancreas Club

Author: YaoXi
Tutor: CuiNaiQiang
School: Tianjin Medical University
Course: In Western medicine combined with surgery
Keywords: Chinese Pancreas Club acute pancreatitis chronic pancreatitispancreatic cancer follow up study
CLC: R576
Type: Master's thesis
Year: 2013
Downloads: 5
Quote: 0
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Abstract


Objective To collect clinical date of patients with acute pancreatitis, chronic pancreatitis as well as pancreatic cancer during hospitalization and after discharge by the platform of "Chinese Pancreas Club". Give medical and life guidance after discharge, and improve the clinician awareness of pancreatic disease as well as clinical treatment level of doctors, then improve life quality of patients.Methods To analyze retrospectively the record of patients who were in Bile and Pancreatic Center of tianjin nankai hospital in recent3years (January2010December2012)for cases of pancreatic surgery diseases. To follow up the patients after discharge by the methods of internet questionnaire, paper-based questionnaire and telephone, then carry through statistical analysis.Result1、The major causes of436AP patients were biliary tract diseases(51.4%), hyperlipidemia(17.9%);For female patients, biliary tract diseases was always the primary causes. For male patients, hyperlipidemia and alcoholic reasons were in the majority; hyperlipidemic acute pancreatitis usually turned sever pancreatitis;28.4%patients retained peripancreatic fluid accumulation not fully absorbed and22.0%patients with abnormal fasting blood-glucose after discharge; more than80%patients with biliary pancreatitis and alcoholic pancreatitis knew their pathogeny, but only45.9%patients with hyperlipidemia pancreatitis realized their pathogeny; AP patients often combined internal and external secretion insufficiency after discharge3months.2、The major pathogenic factors of129CP patients were smoke(88.4%), alcohol(69.0%), hyperlipidemia(36.4%), biliary tract diseases(28.7%)and other reasons(17.1%);There were always at least two kinds of pathogenic factors for most CP patients; Male were more than female for the factors of alcohol and smoke, on the contray, female were more than male for the factors of biliary tract diseases; The abdominal pain of CP patients could be relieved after conservative treatment; The effective rate was100%and significant efficiency rate was94.1%after partial resection of pancreas and open decompression of the pancreatic duct; the operation effect was better than other methods significantly;30.9%CP patients occured pancreatic pseudocyst after discharge;82.1%CP patients knew one kind of pathogenic factor at least; majority of CP patients could quit drinking and treat biliary tract diseases, but rate of quitting smoking is relatively low.3、The male to female ratio was1.63:1in92patients with pancreatic cancer, including64pancreatic head cancer (69.6%),26pancreatic body and tail cancer(28.3%),2total pancreatic cancer(2.2%); The one year survival rate of Ⅰ、ⅡA、 ⅡB、Ⅲ、Ⅳ stage were60.0%、57.1%、45.5%、31.3%and2.7%;There was significant difference between stage IV and other stages about one year survival rate;The one year survival rate(69%) after radical tumor resection is higher than other treatment Conclusion The major causes of AP were biliary tract diseases, hyperlipidemia; For female patients, biliary tract diseases was always the primary causes, For male patients, hyperlipidemia and alcoholic reasons were in the majority. We should pay more attention to hyperlipidemia AP for its severity and complications. AP patients often combined internal and external secretion insufficiency after discharge3months. The major pathogenic factors of CP patients were smoke, alcohol, hyperlipidemia; For male patients, smoke,alcoholic and hyperlipidemia were in the majority; For female patients, smoke, hyperlipidemia and biliary tract diseases were always the primary factors; AP could turn CP on the basis of long-term alcohol consumption/smoking. Symptom could be relief significantly after the "individualized and stepped treatment combined traditional Chinese medicine and western medicine".Proper surgical treatment should be applied to CP with definite operation indication, while conservative treatment was not advised at this time. For patients with pancreatic cancer, one year survival rate after radical tumor resection is higher than other treatment. The construction of Chinese Pancreas Club is important for strengthen the doctor-patient contact, the guidance of the way of life after discharge and improving the prognosis of patients with pancreatic disease.

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CLC: > Medicine, health > Internal Medicine > Digestive and abdominal diseases > Pancreatic diseases
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