胰腺损伤48例诊治分析  

The diagnosis and treatment of 48 cases with pancreatic trauma

作　　者：徐本卫 王成友[2] 

机构地区：[1]中山市火炬开发区医院外科,广东中山528437 [2]深圳市第二人民医院

出　　处：《中国基层医药》2005年第8期1015-1016,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨胰腺损伤的诊断与外科手术治疗方法。方法回顾分析了我院自1997年7月至2005年6月手术治疗48例胰腺损伤的类型、术前诊断以及手术治疗的方法。结果腹部B超、CT以及血尿淀粉酶检测是诊断胰腺损伤的主要方法,但确诊率较低,本组仅有15例(31·25%)患者在术前得到确诊,其余33例(68·75%)患者的胰腺损伤均为剖腹探查时发现。手术方式:缝合、止血+引流术者32例;保留脾脏的胰体尾切除术6例;脾脏+胰体尾切除术6例;十二指肠憩室化手术4例。结论胰腺损伤的术前诊断困难,密切观察病情,及时手术探查,可使胰腺损伤得到早期治疗。术中根据损伤的类型合理选择手术方式。Objective To investigate the method of diagnosis and operation treatment for pancreatic trauma. Methods 48 patients with pancreatic trauma was performed operation in last 8 years, a retrospective analysis was made for their trauma types, preoperative diagnosis and the methods of operation. Results The methods of preoperative diagnosis is main depend on B-ultrasonic. CT,and the analysis of amylase in blood and urine,but the rate of diagnose was low, among 48 cases only 15 （31.25 % ） was confirmed suffered from pancreatic trauma before operation, all other 33 cases was found during operation. Among 48 cases 32 cases underwent pancreatic repair and internal drainage,6 cases underwent spleen preserving distal pancreatectomy,6 cases underwent splenectomy and distal pancreatectomy,4 cases was treated by duodenal diverticulization. Conclusions It is difficult to make preoperative diagnosis of pancreatic trauma,operative exploration should be performed in time if pancreatic trauma under suspicion. Proper surgical management is made according to the classification of pancreatic trauma.

关 键 词：胰腺 损伤 外科手术 胰腺损伤 诊治分析 手术治疗方法 十二指肠憩室化手术 胰体尾切除术 术前诊断 尿淀粉酶检测 

分 类 号：R657.5[医药卫生—外科学] R656.6[医药卫生—临床医学]