当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2013年
36期
60-61
,共2页
胰腺损伤%诊断%治疗
胰腺損傷%診斷%治療
이선손상%진단%치료
Pancreas trauma%Diagnosis%Treatment
目的：探讨胰腺损伤的诊断与治疗方法。方法回顾性分析安徽医科大学第二附属医院急诊科收治的16例胰腺损伤的临床资料。结果2例行保守治疗，4例行胰周清创外引流术，2例行胰头颈部破裂缝合修补和胰周多管引流术，5例行远端胰腺切除和脾切除术，2例行近端胰腺裂口缝合，远端胰腺空肠Roux-en-Y吻合，1例行急诊Whipple术。12例治愈，其中2例术后引流液的淀粉酶升高，考虑胰漏，经引流等保守治疗痊愈，胰腺假性囊肿形成1例，术后2月行内引流术治愈，1例因多器官功能衰竭死亡。结论胰腺损伤早期诊断困难，应结合临床及动态复查B超、CT检查，积极采取早期手术治疗，根据胰腺损伤类型选择适当术式，提高治愈率减少并发症。
目的：探討胰腺損傷的診斷與治療方法。方法迴顧性分析安徽醫科大學第二附屬醫院急診科收治的16例胰腺損傷的臨床資料。結果2例行保守治療，4例行胰週清創外引流術，2例行胰頭頸部破裂縫閤脩補和胰週多管引流術，5例行遠耑胰腺切除和脾切除術，2例行近耑胰腺裂口縫閤，遠耑胰腺空腸Roux-en-Y吻閤，1例行急診Whipple術。12例治愈，其中2例術後引流液的澱粉酶升高，攷慮胰漏，經引流等保守治療痊愈，胰腺假性囊腫形成1例，術後2月行內引流術治愈，1例因多器官功能衰竭死亡。結論胰腺損傷早期診斷睏難，應結閤臨床及動態複查B超、CT檢查，積極採取早期手術治療，根據胰腺損傷類型選擇適噹術式，提高治愈率減少併髮癥。
목적：탐토이선손상적진단여치료방법。방법회고성분석안휘의과대학제이부속의원급진과수치적16례이선손상적림상자료。결과2례행보수치료，4례행이주청창외인류술，2례행이두경부파렬봉합수보화이주다관인류술，5례행원단이선절제화비절제술，2례행근단이선렬구봉합，원단이선공장Roux-en-Y문합，1례행급진Whipple술。12례치유，기중2례술후인류액적정분매승고，고필이루，경인류등보수치료전유，이선가성낭종형성1례，술후2월행내인류술치유，1례인다기관공능쇠갈사망。결론이선손상조기진단곤난，응결합림상급동태복사B초、CT검사，적겁채취조기수술치료，근거이선손상류형선택괄당술식，제고치유솔감소병발증。
Objective To discuss the methods of diagnosis and surgical treatment of pancreatic trauma.Methods Clinical data of the 16 patients with pancreatic trauma treated from 2008 to 2013 was retrospectively analyzed.Rusults Two patients received non-surgery treatment, four patients underwent debridement and drainage; Two patients underwent suture and repair rapture in pancreatic neck also drainage;Five patients with gradeⅢ underwent distal pancreatectomy in combination with splenectomy; Two patients underwent ligature of pancreatic duct and suture repair of the pancreatic head with Roux-en-Y distal pancreaticojejunostomy; one patient underwent the whipple’s procedure.Twelve patients fully recovered of them,Two patients suffered from the pancreatic leakage and recovered with conservative treatment including using pancreas enzyme inhibitor.one patients suffered from pancreatic pseudocyts and recovered with operation.one patient died of muttiple organ failure.Conclusion Early diagnosis of pancreatic trauma is difficult,it should combine the clinicalfindings with repeated BUS and CT scaning.We should approach pancreatic injury according to the classification and the condition of the injury and choosea proper operation method in order to improve the survival rate and diminish the complications.
