损伤控制外科理念在22例胰腺外伤治疗中的应用  

Application of damage control surgery concept application in 22 cases of pancreas trauma

作　　者：余伟 宋政炜 钟征翔 费建国 李军成[2] Yu Wei, Song Zhengwei, Zhong Zhengxiang, Fei Jianguo, Li Juncheng.(Department of Hepatobiliary Surgery, the Second Hospital of Jiaxing, Zhefiang Jiaxing 314000, Chin)

机构地区：[1]浙江省嘉兴市第二医院肝胆外科,314000 [2]苏州大学附属第二医院普外科

出　　处：《中国医师进修杂志》2017年第10期908-911,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨损伤控制外科（DCS）理念在胰腺外伤治疗中的应用。方法回顾性分析2009年1月至2016年6月收治的22例胰腺外伤患者的临床资料，对患者的损伤程度、治疗方法及疗效进行分析。结果遵循DCS理念，3例行保守治疗，19例根据损伤分级分别给予液体复苏、控制合并伤、清创止血、缝合修补、引流和保留胰腺功能手术；治愈21例，死亡1例；术后发生胰瘘11例，腹腔感染6例，创伤性胰腺炎1例，均保守治疗后痊愈；胰腺假性囊肿1例，术后6周手术治愈。术后均获随访，随访时间为12～36（25．1±1．7）个月，存活21例患者术后生活或工作均无明显影响。结论遵循DCS理念，早期诊断和积极治疗，可有效降低胰腺外伤患者病死率，提高治愈率。Objective To investigate the application of damage control surgery （DCS） concept in treatment of pancreas trauma. Methods The clinical data of 22 eases of pancreas trauma from January 2009 to June 2016 were analyzed retrospectively, including degree of injury, therapies and effect. Results Following DCS concept, 3 cases were given conservative treatment, and 19 cases were treated by operation, including debridement, hemostasis, suture, simple drainage and preserved pancreas function; 21 cases were cured and 1 died; pancrestic fistula occurred in 11 cases, abdominal infection occurred in 6 cases and injured pancreatitis occurred in 1 cases by conservative treatment; false cyst occurred in 1 cases 6 weeks after operation. All patients were followed up for 12 - 36 months, with an average of （25.1 ± 1.7） months, and No significant impact was seen on the lives or work of 21 patients after surgery. Conclusions Pancreas trauma needs early-stage diagnosis and active treatment. Rational application of dcs concept can reduce the mortality and improve the outcome effectively.

关 键 词：胰腺外伤 损伤控制外科 治疗 

分 类 号：R657.5[医药卫生—外科学]