胰腺损伤18例诊治体会

EXPERIENCE IN DIAGNOSIS AND TREATMENT OF 18 CASES WITH PANCREAS INJURY

目的 为探讨胰腺损伤时提高诊断和治疗对降低并发症和死亡率的影响。方法 总结近１０年来１８ 例胰腺损伤的资料，分析胰腺损伤的诊断和治疗。结果 治愈１７例，死亡１ 例，发生胰瘘３例，假性胰腺囊肿１例。结论 闭合性胰腺损伤缺乏典型的特征性，诊断的关键是剖腹探查时查清有无胰腺损伤。正确判定胰腺损伤的部位，程度和范围，与合理选择术式密切有关。术后引流，禁食，抑制胰酶分泌，营养支持等综合措施的使用有利于防治并发症。

Objective To study the quality improvement of diagnosis and treatemnt in the cases with pancreas injury,to reduce the complication and mortality.Methods We summariazed 18 cases with pancreas injury in past ten years,and analysed the diagnosis and the treatment of pancreas injury.Results Curative cases were 17 and death was 1,3 cases had pancreatic fistula and 1 cases had pancreatic pseudocyst.Conclusion Because of the deficiency of specific symptom,the key of diagnosis is to discover if there is pancreas injury during exploratory laparotomy.To choose rationally operation program is very important according to the degree,the position,the range of pancreas injury.Postoperative drainage,inhibting pancreatic secretion,nutritive support and so on are beneficial to reduce the complication.