闭合性胰腺损伤的救治  

Diagnosis and surgical treatment of closed pancreatic injury： report on 42 patients

作　　者：郑林海[1] 姜波健[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院普外科,201900

出　　处：《国际外科学杂志》2007年第9期592-595,共4页International Journal of Surgery

摘　　要：目的探讨闭合性胰腺损伤的外科诊治及影响预后的因素。方法对我院1990-2006年收治的42例胰腺损伤病例的临床资料行回顾性分析。结果本组42例中,术前确诊16例,其中闭合性损伤37例,术前确诊15例,术前确诊率分别为38.10%和40.54%。34例治愈,8例死亡,发生并发症19例,术后胰漏是主要并发症。结论胰腺损伤术前诊断困难,剖腹探查术是早期诊断最可靠的方法,CT检查的诊断价值高于B超。根据术中探查情况采取简单而合理的手术方式以及正确的围手术期处理是影响闭合性胰腺损伤预后的主要因素,闭合性胰腺损伤的后期病死率与胰腺的损伤程度密切相关。Objective To explore diagnosis, surgical treatment and prognostic factors of the pancreatic injury. Methods A retrospective analysis was made in 42 patients with pancreatic injury recruited in our hospital from 1990 to 2006. Results In these patients, corrected diagnosis before operation was made in 16 cases. There were 37 patients suffered from closed injury ,among them 15 were correctly diagnosed prcoperation, the rate of diagnosis were 38.1% and 40.54% respectively. Thirty - four cases were cured completely, 8 died and 19 suffered from various complications, among them the pancreatic fistula was the most often. Conclusions It seems to be very difficult for the pre - operative diagnosis of pancreatic closed injury. The abdominal exploration Seems to be the most effective method for its diagnosis and the diagnostic value of CT seems to be more important than that of B ultrasound. The suitable operative selection and the correct perioperative management were important for the prognosis of the disease.

关 键 词：胰腺 损伤 手术 预后 

分 类 号：R657[医药卫生—外科学]