摘要
胰腺创伤在腹部外伤中约占 1 %～ 1 2 % ,而病死率为 0 .5 %～ 32 %。由于胰腺的解剖特点和胰腺创伤常合并多发伤 ,早期诊断较困难 ,临床上应结合受伤情况、血清淀粉酶、B超、内镜 B超及 CT有助于早期诊断。 ERCP是一种诊断胰管损伤的可靠方法 ,腹腔镜检查对胰腺损伤诊断有较大价值 ,剖腹探查仍然是诊断胰腺损伤的可靠方法。主胰管损伤术前确诊不易 ,手术探查也易漏诊 ,对疑有主胰管损伤者可行胰管造影进一步确诊。早期诊断和合理治疗有利于减少并发症和降低病死率。手术方式取决于损伤的程度。正确判断主胰管损伤。
The rate of pancreatic trauma is 1%~12% in abdominal trauma,and the mortality is 0.5%~32%.Because of the character of the pancreatic anatomy and the multiple organ injuries,early diagnosis of pancreatic trauma is still more difficult.It is in favour of early diagnosis that combines with traumatic possition,blood amylopsin,B supersonic,EUS and CT.ERCP is a reliable way to diagnose the trauma of pancreatic duct.There is more valuable with endoscope of abdominal cavity to diagnose the trauma of the pancreas.It is also a reliable way to diagnose the pancreatic trauma with abdominal section.The trauma of the main pancreatic duct is not easy to diagnose before operation,and abdominal section is still easy misdiagnosing.The main pancreatic duct which is suspected trauma should be made cholangiopancreatography.Early diagnosis and treatment are in favour of reducing complication and mortality.The operation mode is depended on the traumatic extent.It is a key that correctly judging the trauma of the main pancreatic duct,and thoroughly eliminating the bad tissue and better suture of pancreas intestine to prevent the pancreatic fistula.
出处
《华夏医学》
2003年第5期747-749,共3页
Acta Medicinae Sinica
关键词
胰腺
创伤
诊治
进展
pancreas
trauma
diagnosis and treatment
progress
