摘要
目的探讨外伤性胰腺损伤的诊断及外科治疗处理方法。方法对2000-12～2009-12收治的42例胰腺外伤的临床资料,包括损伤程度、手术方式、疗效及术后并发症进行回顾性分析。结果Ⅰ、Ⅱ级18例,Ⅲ级10例,Ⅳ级9例,V级5例。单纯缝合引流18例,远端胰腺切除、近端缝合结扎8例,近端缝合结扎、远端与空肠吻合8例,近端与远端直接吻合2例,胰十二指肠切除4例,暂缝扎断端、Ⅱ期手术1例。痊愈38例,病死4例。其中手术前病死(合并颅脑外伤)1例,死于胰漏1例、肠瘘1例、多器官功能衰竭1例。结论外伤性胰腺损伤临床表现隐匿,及早完善检查,明确诊断;要根据胰腺损伤的部位、病情分级和严重程度,决定手术方式,充分引流、预防术后并发症的关键。
Objective To investigate the diagnosis and surgical treatment of traumatic pancreatic injury. Methods Clinical data （from 2000-12 to 2009-12） of 41 patients with pancreatic injury, including injury extent, surgical procedure, efficacy and complications were analyzed retrospectively. Results Among the 41 cases Ⅰ- Ⅱ grade, 18 cases; Ⅲ, 10 cases; Ⅳ, 9 cases; Ⅴ, 5 cases. Simple suture drainage was performed in 18 cases; distal pancreatectomy, proximal suture ligation in 8 cases; suture ligation proximal and distal anastomosis in 8 cases and the jejunum, proximal and distal anastomosis in 2 cases; pancreaticoduodenectomy in 4 cases, temporary suture ends and Ⅱ surgery in 1 case. Evontually, 38 cases recovered, 4 died, of which perioperative deaths （with brain injuries） in 1 case, pancreatic leakage in 1 case; intestinal fistula, in 1 case; multiple organ failure in 1 case. Conclusion The clinical manifestations of traumatic pancreatic injuries is occult; early sound check, a clear diagnosis should be taken; the surgical proccdure should be selected according to pancreatic injury, severity of disease classification; and adequate drainage and to prevent postoperative complications are key issues.
出处
《实用医药杂志》
2010年第11期968-970,共3页
Practical Journal of Medicine & Pharmacy
关键词
外伤
胰腺损伤
诊断
手术治疗
Trauma
Pancreas injury
Diagnosis
Surgical treatment
