闭合性胰腺损伤的诊断和外科治疗

目的 总结闭合性胰腺损伤的诊断和治疗经验.方法 对我院2002年12月～2010年9月收治的36例闭合性胰腺损伤的临床资料进行回顾性分析.结果 胰腺损伤情况,按美国创伤外科学会(AAST)胰腺损伤分级,Ⅰ级7例,Ⅱ级15例,Ⅲ级9例,Ⅳ级5例,无Ⅴ级病例.胰腺损伤术前诊断率40％.23例合并胰腺以外脏器损伤.23例行急诊剖腹探查术,其中17例针对胰腺损伤进行了手术治疗.所有病例均治愈,无死亡病例.结论 闭合性胰腺损伤的诊断需综合应用多种手段,外科手术是其主要治疗方法,非手术治疗应慎重.

Diagnosis and surgical treatment of blunt pancreatic trauma

【Objective】To summarize the experiences of diagnosis and surgical therapeutic strategies of blunt pancreatic trauma.【Methods】The clinical data of 36 cases with blunt pancreatic trauma were analyzed retrospectively from Dec.2002 to Sept.2010.【Results】According to AAST grading criteria,the results were 7 cases of gradeⅠ,15 cases of grade Ⅱ,9 cases of gradeⅢ,5 cases of grade Ⅳ,0 case of grade Ⅴ.Of 25 cases undergoing surgery,the rate of diagnosis of pancreatic trauma were 40% before operation.23 cases were suffered from other organs trauma at the same time.23 cases were performed urgent exploratory laparotomy,of these 23 cases,17 cases were received intervention to aim directly at pancreatic injury.All of the 36 cases were cured and without death cases.【Conclusion】The diagnosis of pancreatic trauma involve utilization of multiple armamentariums and techniques.Surgery is principal therapeutics measure of pancreatic trauma.conservative therapy with avoidance of urgent laparotomy should be applied circumspectly.