探讨闭合性胰腺损伤的诊断与外科治疗

目的 提高闭合性胰腺损伤的早期诊断水平,掌握好探查指征,合理选择手术方式.方法 回顾性分析18年30例闭合性胰腺损伤的诊治过程.结果 闭合性胰腺损伤临床上均有不同程度的上腹疼痛、呕吐、腹膜刺激征.30例患者中休克4例;早期血淀粉酶检查24例,20例阳性;尿淀粉酶16例,8例阳性;腹水淀粉酶8例,均为阳性;腹穿16例均为...

Discussion of Blunt Pancreatic Trauma's Diagnosis and Surgical Treatment

Objective To improve early diagnosis of blunt pancreatic trauma,mastering operative indication and selecting operative program correctly.Methods To review retrospectively the diagnosis and treatment of 30 patients with blunt pancreatic trauma in this hospital in the 18 years.Results The main symptoms of blunt pancreatic trauma were upper abdominal pain,vomiting,acute abdomen.The 4 cases were accompanied by shock.The 20 of 24 cases had high level of serum amylase.The 8 of 16 cases had high level of urinary amylase.The all 8 cases had high level of ascites amylase.Peritoneal puncture was presented in all 16 patients.Ultrasound showed that 12 patients were diagnosed in 24 cases.CT performed in 13 cases there were 11 positive diagnosis.The incidence rate of complications was 46.7%（14/30）,and 3 died.Conclusion Early identification of blunt pancreatic trauma relies on clinical symptoms,signs diagnostic peritoneal puncture,pancreatic amylase,B-us and CT.The result showed their limitations.Improving preoperative accessory examimation,mastering operative indication and selecting operative program correctly would reduce the complication and mortality.