23例胰腺损伤治疗体会

Treatment of 23 Cases Pancreatic Trauma

目的:探讨胰腺损伤的诊断和治疗方法。方法:回顾性分析1992年至2006年收治的23例胰腺损伤患者资料。结果:Ⅰ级损伤6例,Ⅱ级8例,Ⅲ级5例,Ⅳ级3例,Ⅴ级1例;单纯胰腺损伤5例(21.7%),合并其它脏器损伤18例(78.3%),合并休克7例(30.4%)。全组均行手术治疗,术前诊断为胰腺损伤仅5例(21.7%);治愈20例(87%),死亡3例(13%)。结论:胰腺损伤早期诊断困难,剖腹探查仍是早期诊断胰腺损伤的最可靠方法;对怀疑或已明确诊断者宜尽早手术探查。根据损伤程度,选择相应的手术方式,并重视处理并发症,以提高治疗效果。

Objective：To investigate the diagnosis and treatment of pancreatic trauma. Method： Clinical data of the 23 patients with pancreatic trauma treated from 1992 to 2006 was respectively analyzed. Result： There were 6 cases of pancreatic trauma in grade 1 , 8 in grade 2 ,5 in grade 3, 3 in grade 4 and 1 in grade 5. Five patients （21.7 %） with only pancreatic trauma, meanwhile 18 patients （78.3%） were combined with other organ injuries , and 7 patients with shock. Preoperative diagnosis was made only in 5 cases（21.7%）. Operation was performed on 23 cases. Of all cases, 20 were cured（87%）, and 3 died（13%） after operation. Conclusion： Early diagnosis of pancreatic trauma is difficult. Laparotomy exploration is still the most reliable way in early diagnosis. So if the diagnosis of pancreatic trauma is suspected or made, aparotomy exploration should be done as early as possible. The choice of surgical procedure of pancreatic trauma should be made on the basis of the location, type and severity of the pancreatic trauma , and should pay more attention to the treatment of complication so as to achive an ideal surgical treatment effect.