胰腺损伤的诊断和治疗  

Diagnosis and Treatment of Pancreatic Trauma

作　　者：朱勇[1] 王敏[1] 张锐利[1] 卢永明[1] 林祖朝[1] 

机构地区：[1]浙江省台州医院普外科,临海317000

出　　处：《临床急诊杂志》2006年第1期19-20,共2页Journal of Clinical Emergency

摘　　要：目的探讨胰腺损伤的诊断和治疗方法。方法对我院1982年12月～2005年5月间收治的51例胰腺损伤的临床资料进行回顾性分析。按美国创伤协会(AAST)胰腺损伤分级:Ⅰ级9例,Ⅱ级17例,Ⅲ级14例,Ⅳ级8例和Ⅴ级3例。全组病人均手术治疗。胰腺清创加引流24例;胰头侧断端胰管结扎缝合修补、胰体尾切除16例,同时行脾切除7例;胰头侧断端胰管结扎缝合修补、体尾断端胰空肠 Roux-y 吻合4例;胰管吻合修补3例;十二指肠憩室化1例;急诊胰十二指肠切除术3例。结果术前诊断16例(31.4%),46例(90.2%)治愈,5例(9.8%)死于合并伤,发生并发症17例(33.3%)。结论早期诊断、根据胰腺损伤的类型选择合理的手术方式是外科治疗成功与否的关键。Objective To explore the methods of diagnosis and treatment of pancreatic trauma. Methods Chinical data of pancreatic trauma from December 1982 to May 2005 were collected and retrospectively analysed. According to the classification of the pancreatic damage of the american association fro the surgery of trauma. 9 cases were grade Ⅰ , 17 cases of grade Ⅱ , 14 eases of grade Ⅲ ,8 cases of grade Ⅳ ,3 cases of grade Ⅴ. All patients were undergone surgical treatment. Debridement and local drainage were preformed in 24 cases, Broken end of the head of pancreatic duct was ligated and closed with suture and the pancreatic tail was excised in 16 cases and splenectomy was performed in 7 cases at the same time. 4 cases were undergone ligature,closure and suture of the broken end of the pancreatic duct in the pancreatic head and Roux-y pancreaticojejunostomy at the broken end of the pancreatic body. Pancreatic duct anastomosis was performed in 3 cases ,duodenal diverticulum in 1 case and emergency pancreatieoduodeneetomy in 3 cases. Results 16 cases （ 31% ） obtained preoperative diagnosis,46 cases（90.2% ） were cured,5 cases （9. 8% ） died of coexisting injuries and complications occurred in 17 cases（ 33.3% ）. Conclusion Early diagnosis and selecting a reasonable operative procedure is the key to surgical treatment.

关 键 词：胰腺损伤 诊断 治疗 

分 类 号：R657.5[医药卫生—外科学]