胰腺损伤误诊原因及预防

Causes of Misdiagnosis of Pancreatic Injury and Its Countermeasure

目的 探讨胰腺损伤的误诊原因及预防。方法 回顾性分析 1989～ 2 0 0 0年收治的胰腺损伤 17例误诊的原因。结果 痊愈 15例 ,死亡 2例 ,死亡原因为 MODS,死亡率 13.3%。并发胰腺周围脓肿 2例 ,胰腺假性囊肿 3例 ,胰腺外瘘 11例。结论 胰腺位置较深 ,胰腺损伤症状、体征易被掩盖 ;发病率低 ,又无特异性检查方法 ;多发伤患者因其受伤部位多 ,病情危重 ,不容过多探查 ,忽略了胰腺损伤的存在而误诊。通过仔细了解受伤情况、部位及症状、体征 ,CT、ER-CP、术中美兰注射和术中胰。

Objective To explore the causes of misdiagnosis of pancreatic injury and its countermeasure.Methods 17 misdiagnosed patients with pancreatic injury hospitalized between 1989～2000 were analyzed retrospectively. Results 15 of 17 cases with pancreatic injury were cured completely,2 died from MODS(13.3%).2 complicated by peripancreatic abscess,3 by pancreatic pseudocuyst and 11 by tistula of pancreas.Conclusions The symptoms and the signs were easily covered because the pancrea was located in the deep abdominal cavity, and there hasn't specific examination methods.Doctors should carefully check patients and ,if necessary, use ERCP,intraoperative cholangiopancreatography and injection of melanin to reduce its misdiagnosis to the greatest extent.