腹部闭合性胰腺损伤的漏诊原因及预防对策  

Missed Diagnosis Cause and Preventative Measures of Pancreatic Injury

作　　者：门学博[1] 韩恩昆[1] 杜庆云[1] 

机构地区：[1]天津医科大学宝坻临床学院外一科,天津301800

出　　处：《临床误诊误治》2011年第5期14-15,共2页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨腹部闭合性胰腺损伤的误诊原因及预防对策。方法回顾性分析1998年1月～2010年5月我院收治的腹部闭合性胰腺损伤24例的临床资料。结果本组胰腺损伤术前漏诊9例(37.5%)。经B超检查、CT平扫确诊各4例,增强CT扫描确诊7例,剖腹探查时确诊9例。2例单纯胰腺Ⅰ级损伤行保守治疗,22例采取手术治疗。治愈20例,死亡4例,死亡率16.7%。结论对有上腹外伤史者,应高度警惕胰腺损伤,详细询问病史,密切观察病情,及时行CT检查和全面细致的剖腹探查可减少漏诊。Objective To investigate the missed diagnosis cause and preventative measures of pancreatic injury. Methods The clinical data of 24 cases of pancreatic injury admitted from January 1998 to May 2010 was retrospectively anayzed. Results 9 patients （37.5%） were missed diagnosed before surgery. 4 patients were diagnosed by CT and B-type ultrasonography, 7 were diagnosed by enhancement CT, and 9 patients were diagnosed by exploratory laparotomy. 2 patients with simple gradeI pancreatic injury received expectant treatment, and 22 patients underwent surgery. The treatment outcome was as follows ： 20 healed and 4. deaths, and the mortality rate was 16.7%. Conclusion Doctors should pay attention to pancreatic injury in case of epigastric trauma. Inquesting medical history in details, observing pathogenctic condition closely, taking CT detection and exploratory laparotomy in early stage may reduce missed diagnosis.

关 键 词：腹部损伤 胰腺 误诊 

分 类 号：R657.5[医药卫生—外科学]