闭合性胰腺损伤漏误诊的原因和防范措施

目的通过对闭合性胰腺损伤临床资料的分析 ,总结漏误诊的原因并提出防范措施 ,以便提高诊疗水平。方法回顾性分析我院 1993年 4月～ 2 0 0 3年 11月收治的 15例闭合性胰腺损伤术前、术中漏误诊的原因。结果本组术前基本明确诊断 5例 ,9例经首次手术探查确诊 ;漏误诊 10例 ,1例经 2次手术方确诊。结论外科医生必须重视闭合性胰腺损伤 ,采取各种有效的防范措施以最大可能减少漏误诊 ,使病人早期获得合理治疗 ,减少并发症和降低病死率。

Missed and mistaken diagnosis of closed pancreatic injury:causes and precautions

Objective To sum up the causes for missed and mistaken diagnosis of closed pancreatic injury and propose some precaustions against them by performing a analysis on the clinical data in order to improve diagnosis and management of the disorder. Methods A retropective analysis was performed on 15 patients with closed pancreatic injury hospitalized from April,1993 to Novermber,2003.The focus was put on the causes for preoperative and operative misdiagnosis. Results In this group,the confirmed diagnosis of closed pancreatic injury was preoperatively obtained in 5 cases;it was established with laprotomy in 9 patients;1 was only confirmedly diagnosed after the second laprotomy.Therefore,missed and mistaken diagnosis happened to 10 cases. Conclusions Surgeons are expected to pay close attention to closed pancreatic injury,to take all effective precautions in order to reduce the occurrence of missed and mistaken diagnosis.In this way,patients could be reasonably treated at early stage and the complications and mortality wcould be decreased.