摘要
目的探讨胰腺损伤的诊断、外科处理及并发症的防治。方法回顾分析2002～2011年73例胰腺损伤病例的临床资料。结果本组男性66例,女性7例,年龄12～60岁,钝性伤67例(91.8%),锐性穿透伤6例(8.2%),休克35例,合并3个以上脏器损伤者56例。胰腺损伤Ⅰ级48例,Ⅱ级15例,Ⅲ级4例,Ⅳ级4例,Ⅴ级2例。单纯胰腺损伤5例(6.8%),合并其它脏器损伤68例(93.2%)。术前诊断5例,69例行手术治疗,术后并发胰瘘8例,胰腺周围脓肿4例,假性胰腺囊肿3例,64例痊愈,7例死亡(9.6%)。结论早期诊断胰腺损伤困难,关键在于对腹部外伤的患者应考虑到有胰腺损伤的可能,行相关的检查。动态B超、增强CT、磁共振胰胆管成像(MRCP)等检查是诊断胰腺损伤的重要方法。根据胰腺损伤的程度、部位选择及时、合理的手术方式是减少术后并发症和改善预后的关键。
Objective To explore the methods of diagnosis and treatment of pancreatic injuries. Methods The clinical data of 73 cases with pancreatic injuries in the past 9 years were analyzed retrospectively. Results All cases include 66 male and 7 fe- male aged between 12 -60 years old, blunt trauma in 67 cases and penetrating injuries in 6 cases. Of all cases, 35 cases with shock while 56 eases with three or more organ damage. There were 48 cases of pancreatic trauma in grade 1 , 15 in grade 2,4 in grade 3,4 in grade 4,2 in grade 5. Five patients （6.8%） with only pancreatic trauma, meanwhile 68 patients （93.2%） were combined with other organ injuries. Preoperative diagnosis was made only in five cases （6.8%）. Operation was performed in 69 cases. 8 cases complicated with pancreatic leakage ,4 cases with abscess around the pancreas, and 3 cases with pancreatic pseudo- cyst. 64 cases were cured（ 87.7% ） and 7 cases died（9.6% ） after the operation. Conclusion For early diagnosis of pancreatic trauma, it is important to be aware of potential for this injury after abdominal trauma. The dynamic B-mode uhrasouography, en- hancement CT and MRCP are important methods in diagnosing pancreatic injury. The key procedure for improving prognosis and reducing the postoperative complications is to take timely and rational operative procedures according to the degrees and regions of pancreatic trauma.
出处
《中华全科医学》
2012年第11期1721-1722,共2页
Chinese Journal of General Practice
关键词
胰腺损伤
诊断
治疗
Pancreatic injury
Diagnosis
Treatment
