摘要
目的总结创伤性胰腺外伤的诊断及治疗经验。方法对本院1993年8月-2012年9月收治的60例胰腺外伤患者的临床资料进行回顾性分析。结果根据美国创伤外科协会(American Association for the Surgery of Trauma,AAST)胰腺损伤分级,本组60例中,Ⅰ级损伤25例,Ⅱ级损伤19例,Ⅲ级损伤6例,Ⅳ级损伤6例,V级损伤4例。保守治疗17例,手术治疗43例。29例行胰腺损伤修补并放置引流,胰腺空肠吻合5例,行胰十二指肠切除2例,胰体尾切除1例,手术探查4例,一期清创,二期行胰肠吻合2例。治愈54例,死亡4例,放弃治疗2例。无并发症29例,并发胰漏15例,胰腺假性囊肿8例,腹腔感染9例,胰管狭窄1例,多器官功能衰竭(multiple organ failure,MOF)2例。结论胰腺损伤的治疗要根据具体伤情来决定手术方式。对于严重的胰腺损伤,要遵循损伤控制性手术的原则,术后充分引流是预防术后并发症的关键。
Objective To summarize the experience in diagnosis and treatment of traumatic pancreatic injury. Methods Clinical data about 60 patients with pancreatic injury admitted to our hospital from August 1993 to September 2012 were retrospectively analyzed. Results Of the 60 traumatic pancreatic injury patients, 25 were classified as grade Ⅰ injury, 19 as grade Ⅱ injury , 6 as grade Ⅲ injury , 6 as grade Ⅳ injury and 4 as grade Ⅴ injury according to the AAST classification. Of these patients, 17 underwent conservative treatment and 43 underwent surgical treatment. Of the 43 patients who underwent surgical treatment, 29 underwent pancreatic injury repair and drainage, 5 pancreaticojejunostomy, 2 pancreatoduodenectomy, 1 distal pancrea resection, 4 operative exploration, 2 primary debridement and secondary pancreaticojejunostomy. Of the 60 patients, 54 were cured, 4 died and 2 gave up treatment, with no complication occurred in 29, but pancreatic fistula in 15, abdominal infection in 9, pancreatic pseudocyst in 8, pancreatic duct stenosis in 1, multiple organ failure in 2. Conclusion Surgical procedure for the treatment of pancreatic injury should be decided according to its specific condition. Damage-control procedure should be performed for severe pancreatic injury. Sufficient postoperative drainage is the key to the prevention of complications after operation.
出处
《解放军医学院学报》
CAS
2013年第11期1152-1154,共3页
Academic Journal of Chinese PLA Medical School
