闭合性胰腺损伤的处理与预后因素分析

Analysis of prognostic factors and managements of the blunt pancreatic trauma

目的 探讨闭合性胰腺损伤的处理及影响预后的因素。方法 对我院 1993年 2月～ 2 0 0 3年 1月收治的 3 8例闭合性胰腺损伤病例的临床资料进行回顾性分析。结果 3 8例中 ,术前确诊 17例 ( 4 4.7% ) ,3 5例治愈 ( 92 .1% ) ,3例死亡 ( 7.9% ) ;发生并发症 8例 ( 2 1.1% ) ,术后继发出血和胰漏是主要的并发症。结论 闭合性胰腺损伤术前诊断困难。根据术中探查情况采取简单而合理的手术方式是外科治疗的关键。正确的围手术期处理是影响胰腺损伤预后的主要因素。

Objective To investigate the prognostic factors and managements of the blunt pancreastic trauma.Methods Clinical data of blunt pancreatic trauma from Feb 1993 to Jan 2003 were collected and retrospectively analysed.Results In this series, seventeen cases (44.7%) got preoperative diagnosis,35 cases(92.1%) were cured,and 3 died(7.9%),complications occurred in 8(21.1%).Haemorrhage and pancreatic leak are the main complications.Conclusions Preoperative diagnosis of the blunt pancreatic trauma is difficulty.Simple and reasonable surgical procedure is very important for blunt pancreatic trauma according to operative exploration.Perioperative care and management are the major prognostic factors.