胰腺损伤的诊断及外科处理

Diagnosis and Surgical Treatment of 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1990～2003年收治的25例胰腺损伤的临床资料。结果 胰腺损伤I级12例,II级6例,III级4例,IV级3例。胰腺远端切除术2例,胰腺近端缝合关闭远端与Roux-en-y吻合5例,治愈24例,死亡1例。结论 胰腺损伤早期,术前诊断困难,对怀疑有胰腺损伤者,应尽早手术探查,并根据胰腺损伤情况选择合理的手术方式,引流要通畅,术后加强营养支持。

Objective To investigate the diagnosis and treatment of pancreatic trauma. Methodsclinical data of the 25 patients with pancreatic trauma treated from 1990to 2003 was retrospectivelyanalyzed. Results There were 12 cases of pancreatic trauma in gradel,6 in grade 2, 4 in grade 3,3 in grade 4. There were 2 cases of distal pancreatic ectomy.5 cass of proximal pancreatic seam and DnVal’s Roux-en-y pancreaticojejunostomy,24 were cured,and 1 died. Conclusion Early diagnosis of pancre-atic trauma is difficult,so if the diagnosis of pancreatic trauma is suspected,should be done as earlyas possible.The choice of surgical procedure of pancreatic trauma should be made on the basis of thepancreatic trauma. Drain should be trough free and strengthen trophotherapy after operation.