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本文报告胰管蛔虫症44例,讨论蛔虫引起的病理变化及诊疗方法。除嵌入胰管太紧或钻入太深者外,大部份蛔虫可自动退出胰管。其损害大小依阻塞部位、程度和时间而定。全虫进入胰管的危害性大于嵌在壶腹和盘于胰尾者。均有胆绞痛、胆管炎和胰腺炎表现,86%为急性胰腺炎。14%反复发作性慢性胰腺炎。B超、ERCP等发现壶腹、胰管蛔虫和显微镜发现虫卵。或急性胰腺炎伴有胆道或十二指肠蛔虫者可确诊。由于82%蛔虫嵌于壶腹部,抗炎和解痉可促其退出胰管,无效者亦便于内镜拔除。少数位于胰体尾部或伴炎症性肿块,或为坏死性胰腺炎仍需手术治疗。
This article reports 44 cases of ascariasis of the pancreatic duct, to discuss the pathological changes caused by roundworms and diagnosis and treatment methods. In addition to embedding the pancreatic duct is too tight or drill too deep, most roundworms can automatically exit the pancreatic duct. The size of the damage depends on the location of the obstruction, extent and time. All insects into the pancreatic duct is more harmful than embedded in the ampulla and dish in the tail of the pancreas. Have biliary colic, cholangitis and pancreatitis performance, 86% of acute pancreatitis. 14% recurrent chronic pancreatitis. B ultrasound, ERCP found ampulla, pancreatic duct roundworm and microscope to find eggs. Or acute pancreatitis associated with biliary or duodenal roundworm who can be diagnosed. As 82% of roundworms embedded in the ampulla, anti-inflammatory and antispasmodic can promote its withdrawal from the pancreatic duct, ineffective also facilitate endoscopic removal. A small number of pancreatic body in the tail or with inflammatory mass, or necrotizing pancreatitis still need surgery.