闭合性胰腺损伤的诊断和治疗

摘要

目的 探讨闭合性胰腺损伤的治疗.方法 分析我院近5年来收治的81例确诊为胰腺损伤患者的临床资料.结果 术前B超检查阳性率为44.00%,CT检查阳性率为47.66%,腹腔穿刺液淀粉酶(Ams)升高占57.35%,血Ams升高占59.49%,尿Ams升高占53.6%.保守治疗17例,手术治疗64例,死亡9例.病死率为11.11%.结论 腹部闭合性损伤中胰腺损伤术前诊断较困难,外科医生要提高对胰腺损伤的警惕性,综合多种检查,及早明确诊断.视胰腺损伤的程度及合并伤选择合理的治疗方式、手术术式,对循环稳定的Ⅰ、Ⅱ级单纯胰腺损伤患者可行保守治疗,有合并伤者及Ⅲ～Ⅴ级胰腺损伤者则宜行手术治疗.%Objective To investigate the diagnoses and treatment of blunt pancreatic trauma.Methods The clinical data of 81 patients with blunt pancreatic trauma were analyzed retrospectively.Results The positive diagnosis rate was 44.0％ for BUS examination, but 44.76％ for CT scanning.The Amylases in the abdominal fluid, blood, urine were examined, with positive rate of 57.35％, 59.49％ and 53.16％, respectively.17 patients received conservative treatment, while 64 patients received surgical treatment, with total mortality of 11.11％ (9/81).Conclusion It is difficult to diagnose of blunt pancreatic trauma.It is important to alert the pancreatic trauma for the surgeons and all examines should be taken into consideration.