胰腺损伤的救治(附26例报告)

Diagnosis and treatment of pancreatic trauma:report of 26 cases

目的 探讨胰腺损伤的救治方法。方法 回顾性分析 2 6例胰腺损伤的临床资料。结果 2 6例中合并伤 2 2例 (84 .6 % ) ,其中尤以肝、胃损伤多见。手术 2 1例 ,保守治疗 5例 ;并发症 10例 ,其中胰瘘 4例 ,外伤性胰腺炎 2例 ,腹腔脓肿 1例 ,胰腺假性囊肿 3例。治愈 2 2例 ;死亡 4例 ,其中 2例在伤后 4 8小时内分别死于急性呼吸窘迫综合征 (ARDS)和多器官功能不全综合征 (MODS)。结论 及时判明有无主胰管损伤 ,用适当的手术方式、通畅的引流、恰当的药物治疗是减少其并发症、降低死亡率、加快康复的关键。

Objective To investigate the diagnosis and management of traumatic pancreatic injury.?Methods A retrospective review of 26 patients with pancreatic injury admitted to our hospital over a 10 year period was performed.?Results Twenty two cases had associated injures(84.6%),especially liver and stomach injuries. Twenty one cases were operated. Complication occurred in 10 cases,including pancreatic fistula in 4 cases,pancreatitis in 2 cases,intra peritoneal abscess in 1 case,pancreatic pseudocyst in 3 cases. Twenty two cases recovered. There were 4 deaths(Mortality 15.4%) ,2 died within first 48 hours due to ARDS and MODS.?Conclusion Early diagnosis of injuries of main pancreatic duct,proper procedure,medical treatment and free drainage are the key for reducing complications and mortality and accelerating recovery.