摘要
胰腺战创伤较为少见,存在诊断困难,并发症复杂的特点。根据致病机制不同,胰腺创伤(PI)可分为钝性创伤和穿透性创伤。战争所致的PI以穿透性创伤为主,常合并周围重要器官、血管损伤,病情更加危重。PI初期临床表现和影像学特征均不明显,漏诊率高。延迟诊断会提高患者的死亡率,因此动态监测、及时复查十分必要。低级别PI可通过非手术治疗获得较好的预后,高级别PI则大多需要接受手术治疗。损伤控制手术在挽救患者生命,减少并发症方面具有显著优势。随着重症监护水平的提升以及微创干预技术的进步,在部分高级别PI中也开始了微创治疗的尝试。文章回顾了国内外PI诊疗最新进展,结合胰腺战创伤自身特点,就其救治相关问题作一探讨。
War-related pancreatic injury(PI)is relatively rare but presents significant diagnostic challenges and complex complications.According to different pathogenic mechanisms,PI can be categorized into blunt trauma and penetrating trauma,with the latter being more common in war-related injuries.War-related PI is often accompanied by damage to adjacent vital organs and blood vessels,leading to a more critical condition.In the early stages,the clinical manifestations and imaging features of PI are often subtle,which increases the risk of missed diagnoses.Delayed diagnosis and treatment can significantly raise patient mortality rates,making dynamic monitoring and timely reassessment crucial for effective management.Low-grade pancreatic injuries are generally amenable to non-surgical treatment and have a favorable prognosis,while high-grade injuries typically necessitate surgical intervention.The damage control surgery has proven beneficial in saving lives and minimizing complications.With the continuous advancements in intensive care and minimally invasive techniques,there have been emerging efforts to apply minimally invasive treatments in cases of high-grade PI.This article reviews the latest progress in clinical management of PI at home and abroad.Combined with the characteristics of PI,it discusses the related issues of its rescue.
作者
孙冉
童智慧
SUN Ran;TONG Zhihui(Department of Critical Care Medicine,Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University/General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)
出处
《医学研究与战创伤救治》
北大核心
2025年第8期785-790,共6页
Journal of Medical Research & Combat Trauma Care
关键词
胰腺
战创伤
胰腺创伤
损伤控制手术
pancreas
war injury
pancreatic injury
damage control surgery
