闭合性胰腺损伤58例临床分析

目的：总结闭合性胰腺损伤的诊治经验,提高其诊断、手术及并发症防治水平。方法：回顾性分析58例闭合性胰腺损伤的一般资料、致伤原因、临床表现、合并伤、诊疗经过与预后,并按损伤严重程度分组,采用x2检验与Fisher确切概率法进行轻、重度伤组间比较分析。结果：轻度胰腺损伤32例、重度胰腺损伤26例。交通意外为最常见的致伤原因（75.9%）,合并伤50例（86.3%）,CT诊断符合率44.0%;1例非手术治疗,57例于伤后2～36小时内剖腹手术。术后23例（40.4%）发生并发症,胰瘘为最常见并发症（26.3%）。治愈53例,死亡5例（8.6%）。结论：闭合性胰腺损伤早期诊断,及时有效手术是治疗成功的关键。

Clinical Analysis of 58 Patients with Pancreatic Trauma

Objective： To summarize the experience of diagnosis and treatment for blunt pancreatic trauma so as to improve the efficacy of diagnosis and management.Methods： the data of clinical course,injury classification,diagnostic methods,complicated injuries,surgical management and outcomes of 58 patients with blunt pancreatic trauma were retrospectively analyzed.Groups of light injury and severe injury were divided,and comparisons were made with chi squareor Fisher＇s exact test.Results： 32 patients were defined as light injury and the other 26 severe injury.Traffic accident was the major cause of injury.50 patients （86.3%） were complicated with other injuries.The accordance rate of CT diagnosis was 44.0%.Laparotomy was performed within 2 to 36 hours after injury in 57 patients.The incidence of pancreatic trauma-related complications was 40.4%,and the most common one was pancreatic fistula （26.3%）.The over all mortality rate was 8.6% （5patients）.Conclusion： The current diagnosis,prompt and effective surgical procedure maybe the key to successful treatment for blunt pancreatic trauma.