摘要
目的:报道7例小儿胰腺损伤的临床表现、诊断方法及治疗原则。方法:1981年来治疗7例胰腺损伤,4例单纯损伤中3例保守治疗,1例手术外引流;2例分别伴有脾破裂及胃穿孔,行脾切除及胃穿孔修补;1例胰腺颈体部横断伴十二指肠断裂行胰腺远、近端与空肠端端、端侧 Roux-en-Y 吻合、胃空肠吻合。结果:随访3个月至14年,疗效满意。行保守治疗中有1例发生假性胰腺囊肿,6个月时自行消失;2例胰瘘在引流及应用 TPN 后33天及49天痊愈。结论:对腹部外伤,腹痛伴持续血清淀粉酶升高的患儿需行腹部 B 超及 CT 检查,根据胰腺损伤的范围和程度采用不同的治疗方法。
Objective:To investigate the characteristics of clinical manifestations,disagnostic measures and treatment for pancreatic trauma in children.Methods:Seven cases have been treated since 1981.Three of the 4 with simple pancreatic injury received conservative treatment,and ex- ternal drainage to the other one.Two patients associated with spleen rupture and gastric perfora- tion underwent splenectomy and gastrorrhaphy.One case with transection between the neck and body of pancreas and duodenal disruption underwent 2 Roux-en-y pancreaticojejunostomies that the proximal and distal pancreatic stump anastomosed to the jejunum respectively,and gastroje- junostomy in addition.Results:All patients were followed-up from 3 months to 14 years.One de- veloped a pancreatic pseudocyst which disappeared spontaneously in 6th months.Two pancreatic fistula cured after external drainage and TPN in 33rd and 47th day respectively.Conclusion:Per- sistent increase of serum amylase and continuous abdominal pain indicate the need of repeated adominal B-mode ultrasound or CT scan examinations in children with blunt abdominal trauma. Different therapies should e given according to the patterns of injury of the pancreas.
出处
《中华小儿外科杂志》
CSCD
1997年第4期219-221,共3页
Chinese Journal of Pediatric Surgery
