胰腺外伤的诊治37例分析

Diagnosis and treatment for 37 cases of pancreatic injury

目的:回顾分析胰腺外伤患者的临床表现与治疗方法,总结胰腺外伤的诊治经验。方法:收集37例胰腺外伤的病例资料进行回顾性分析。所有患者均行急诊手术,根据胰腺损伤程度选择治疗的不同术式:清创引流、远端胰腺与脾切除、远端或近端胰腺空肠吻合及胰十二指肠切除术。结果:治愈34例(治愈率91.9%),死亡3例(死亡率8.1%);胰漏发生8例(发生率21.2%),胰腺假性囊肿8例,胰周脓肿10例,应激性溃疡5例,出血坏死胰腺炎4例,多器官功能衰竭(MOF)8例。结论:胰腺外伤的诊断是否及时、胰腺损伤与其并发症的严重程度及治疗恰当与否是影响预后的关键。

Aim： To analyze the experience with treating pancreatic injury. Methods- Thirty-seven cases of pancreatic injury underwent emergency opreation. Operation style depended on severity of pancreatic injury, dehridement and water-spreading, tail-panereatectomy and spleneetomy, proximal end or distant pancreas-jejunum ananstomosis, panereatoduodenectomy. Results： Thirty-four cases were cured （ cure rate 91.9% ）, 3 cases died （dead rate 8.1% ）, pancreatic fistula 8 cases （21.2%） , peripanereatie abscess 8 cases, stress ulcer 5 cases, severe acute panereatitis 4 cases, MOF 8 cases. Conclusion： The factors of influencing prognosis： timing of diagnosis of pancreas trauma severity of pancreas injury and complications, appropriate treatment.