CAJ | 학술논문

目的探讨胰腺损伤的诊断和治疗策略.方法回顾性分析1990年1月至2011年12月福建医科大学省立临床医学院收治的36例胰腺损伤的病例资料.结果术前诊断胰腺损伤14例(39％),余均经术中探查确诊.非手术治疗2例,手术治疗34例:胰腺清创引流23例,远端胰腺切除6例(其中同时切除脾脏4例),近端胰腺缝闭、远端胰腺空肠Roux-Y吻合术4例,胰十二指肠切除1例.治愈31例(86％),死亡5例(14％).结论多数胰腺损伤须经剖腹探查确诊.胰腺损伤治疗以手术为主.非手术治疗主要局限于腹膜炎症状轻微、影像学检查未发现主胰管损伤并排除其他腹腔脏器合并伤的Ⅰ、Ⅱ级损伤.术式根据胰腺损伤的分级、合并伤及全身情况合理选择.
목적 탐토이선손상적진단화치료책략.방법 회고성분석1990년1월지2011년12월복건의과대학성립림상의학원수치적36례이선손상적병례자료.결과 술전진단이선손상14례(39％),여균경술중탐사학진.비수술치료2례,수술치료34례:이선청창인류23례,원단이선절제6례(기중동시절제비장4례),근단이선봉폐、원단이선공장Roux-Y문합술4례,이십이지장절제1례.치유31례(86％),사망5례(14％).결론 다수이선손상수경부복탐사학진.이선손상치료이수술위주.비수술치료주요국한우복막염증상경미、영상학검사미발현주이관손상병배제기타복강장기합병상적Ⅰ、Ⅱ급손상.술식근거이선손상적분급、합병상급전신정황합리선택.
Objective To summarize the experience of diagnosis and treatment strategy of pancreatic injury.Methods The data of 36 cases of pancreatic injurics admitted to Fujian Medical University Provincial Clinical College from 1990 to 2011 were analyzed retrospectively.Results 14 cases(39％)were diagnosed preoperatively,and the other cases were diagnosed during the laparotomy.2 cases underwent non-surgical treatment.34 cases underwent surgical treatment,among whom 23 cases underwent pancreatic debridement and drainage,6 cases underwent distal pancreatectomy(4 cases undergoing distal pancreatectomy plus splenectomy included),4 cases underwent distal Roux-Y pancreajejunostomy plus proximal pancreas closure,and 1 case underwent pancreatoduodenectomy.31 cases (86％) were cured,and 5 cases died (14％).Conclusions Most of the pancreatic injury is diagnosed through laparotomy.Surgical opcration is the main approach to treat pancreatic injury.Nonsurgical treatment is primarily limited to grade Ⅰ and Ⅱ pancreatic injury without obvious peritonitis,major pancreatic duct injury,and associated injuries.Surgical procedure should be selected based on the grading scale of pancreatic injury,associated injuries and overall conditions of the patient.