胰腺损伤81例诊治分析

Diagnosis and treatment of pancreatic injury 81 cases analysis

目的探讨胰腺损伤的临床诊断与治疗方法。方法对1998年2月至2012年2月收治的两个医院共计81例胰腺损伤患者的临床资料进行回顾性分析,观察并总结胰腺损伤的临床诊治方法。结果 59例(72.84%)患者痊愈,18例(22.22%)患者好转,4例(4.94%)患者死亡。1例患者死于严重颅脑损伤与合并休克,1例患者死于胰漏、严重腹腔感染,1例患者死于腹腔大出血,1例患者死于严重合并伤及多器官功能不全综合征,总体死亡率为4.94%。术后11例患者出现胸腔积液,3例患者出现腹腔积液,1例患者合并腹腔出血,4例患者术后出现伤口感染,6例患者出现胰漏,3例出现胰周假性囊肿,1例患者发生腹泻。经过对症处理后,患者并发症症状得到明显改善。结论应综合胰腺损伤患者的临床表现、淀粉酶水平、影像学检查进行明确诊断,合理选择治疗方式以降低患者死亡率,显著提高其生活质量。

Objective To explore the clinical diagnosis of pancreatic injury and therapeutic methods.Methods from February 1998 to February 2012,two hospital were a total of 81 cases of pancreatic trauma patients clinical data were retrospectively analyzed,to observe and summarize the clinical diagnosis and treatment of pancreatic injury.Results 59 cases (72.84%) patients healed,18 cases (22.22%) patients get better,4 cases (4.94%) patients died.One patient died of severe craniocerebral injury and merge shock,1 patients died of pancreatic leakage,severe abdominal cavity infection,1 patients died in abdominal cavity hemorrhage,1 patients died of serious injury and combined multiple organ dysfunction syndrome,total mortality was 4.94%.The 11 patients appeared pleural effusion,3 cases (abdominal cavity effusion,1 patients merger abdominal bleeding,4 cases occured wound infection,6 patients appeared pancreatic leakage,and 3cases pancratic pseudocysts ,1 cases diarrhea,After symptomatic and drainage treatment,the patient complications symptoms have been improved obviously.Conclusion patients with pancreatic injury should be comprehensive clinical manifestation,amylase level,imaging examination in diagnosis and reasonable treatment choice to reduce the mortality of patients,improve the quality of life.