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Зависимость болевого синдрома и качества жизни больных хроническим панкреатитом от патоморфологических изменений поджелудочной железы

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Проведен анализ патоморфологических изменений поджелудочной железы у больных хроническим панкреатитом и их взаимосвязь с уровнем болевого синдрома и качеством жизни до оперативного лечения. Полученные результаты подтверждают чрезвычайно низкий уровень качества жизни пациентов с хроническим панкреатитом: физический компонент здоровья составил 43,4 (41,1–48,5) балла, психический компонент – 37,4 (32,3–43,0) балла. Кроме того, у пациентов отмечен выраженный болевой синдром, который составил 7 (6–8) баллов по визуальной аналоговой шкале. Независимо от патоморфологических изменений указанные данные статистически не различались. Доказано, что степень фиброзных изменений головки поджелудочной железы не является единственным фактором развития боли. Увеличение головки поджелудочной железы и расширение протока поджелудочной железы на фоне панкреатической гипертензии не коррелируют со степенью развития фиброза. У пациентов со степенью фиброзных изменений головки поджелудочной железы менее 25% интенсивность болевого синдрома была сравнима с группой пациентов со степенью фиброза более 50%. Аналогичные данные получены и при сравнении качества жизни.

Ключевые слова:
качество жизни, хронический панкреатит, фиброз.

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Pain Syndrome and Quality of Life Dependence from the Pancreatic Pathomorphologic Alterations in the Chronic Pancreatitis Patients

An analysis of pancreatic pathomorphological alterations in chronic pancreatitis (CP) patients and their relationship to the level of pain and quality of life before surgery was carried out. The results confirm the extremely low level of quality of life in CP patients: the physical component of health score was 43.4 (41.1–48.5), mental component 37.4 (32.3–43.0) points. In addition, patients noted marked pain syndrome, assessed as 7 (6–8) points on a visual analogue scale. Regardless of the pathological changes these data are not statistically different. It is proved that the degree of fibrosis pancreatic head is not the only factor of the pancreatic pain development. Increased pancreatic head and extension of the main pancreatic duct on the background of pancreatic hypertension do not correlate with the degree of fibrosis. In patients with the degree of fibrosis pancreatic head less than 25% level of pain was comparable with the group of patients with the degree of fibrosis of more than 50%. Similar results were obtained when comparing the quality of life.

Keywords:
quality of life, chronic pancreatitis, fibrosis.