闭合性胰腺损伤延误手术分析

目的 分析闭合性胰腺损伤延误手术的原因。方法 回顾性分析了下年来闭合性胰腺损伤延误手术治疗９例患者诊治过程。结果 胰腺闭合性损伤延误手术占胰腺闭合笥损伤手术６４％临床上均有不同程度上腹疼痛、呕吐、腹膜刺激征，伴休克２例。术前血淀粉权衡利弊检查６例，５例阳性；尿淀粉酶４例２例阳性，腹水淀粉酶检查３例，均为阳性。腹穿８例均阳性。Ｂ超共６例，确诊３例，ＣＴ检查３例，确诊１例。并发症发生率８０％。死亡１

DILEMMAS IN THE DIAGNOSIS AND OPERATION FOR BLUNT PANCREATIC TRAUMA

Objective To explore the reasons of delayed operation for blunt pancreatic trauma.Metheds Retrospective review the diagnosis and treatment of nine patients with blunt pancreatic trauma who admitted to The First Affiliated Hospital of Anhui Medical University.Results The operation was delayed in 9 patients with blunt pancreatic trauma(64%).The upper abdominal pain was complained in all cases accompanied by nausea,vomiting and slightly or obviously peritoneal irritation.2 of 9 cases were accompanied by shock.5 of 6 cases had high level of serum amylase.2 of 4 cases had high level of urinary amylase.Peritoneal fluid was present in 8 patients.Seven cases had complications and one died.Conclusions Early identification of blunt pancreatic trauma relies on clinic symptoms,signs,diagnostic peritoneal puncture,pancreatic amylase,B-us and CT.The results showed that limitations in each preoperative accessory examination may results in operative delays and potentially increased complications and mortality.Magnetic resonance cholangiopancreatography(MRCP)may helpful for the diagnosis.