胰腺损伤的诊治体会

１９８６年１月～１９９４年１月我们共收治胰腺损伤２４例，虽有许多辅助诊断手段，但受病情限制胰腺损伤的性质和部位往往要在手术探查时确定。浅表裂伤的８例经清创、缝合和引流治愈；胰体尾部较重裂伤的１０例中有８例行胰体尾部切除治愈。Ｒｏｕｘ－Ｙ胰肠吻合治疗胰头颈部损伤４例；合并十二指肠破裂的２例胰头部损伤用十二指肠憩室化治疗。对较重的胰腺损伤放置空肠造瘘管，从造瘘管滴入要素饮食；发生胰瘘时除加重吸引外，使用６５４－２和５－Ｆｕ以抑制胰液分泌。本组治愈２０例，死亡４例，死亡率为１６．７％。

THE DIAGNOSIS AND TREATMENT OF PANCREATIC TRAUMA

rom January 1986 to January 1994, 24 patients with pancreatic traumawere admitted to our hospital. Inspite of many adjuvant diagnostic tools, accu-rate diagnosis usually could only be established after careful exploration duringoperation. 8 patients with pancreatic contusion were cured by debridement, su-turing and drainage , 8 of 10 patients with pancreatic laceration were treated bydistal pancreatectomy. 4 patients with pancreatic head and neck laceration weretreated by Roux-en-Y distal pancreatico-jejunostomy, 2 patients with pancreaticinjury associated with duodenal injury were treated by duodenal divertic-ulization. Jejunostomy was used for severe pancreatic trauma to serve elementaldiets. 654-2 and 5-Fu were given to inhibit the secreation of the pancreas. 20 pa-tients were cured, 4 died. The mortality rate was 16. 7%.