Diagnosis and Treatment of Blunt Pancreatic Trauma in 16 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

张青平 , 赵志勇 , 林武华

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Keywords：

胰腺损伤; 诊断; 并发症; 胰瘘; 吻合术

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　目的　探讨闭合性胰腺损伤的诊断和合理的手术方式。
　方法　对我院2005～2008年期间收治的16例闭合性胰腺损伤患者的临床资料进行回顾性分析。
　结果　本组术前确诊5例，另11例在术中确诊。根据胰腺损伤的不同分级进行相应的手术治疗，手术均顺利完成。术后无一例出现胰瘘，但出现胰腺假性囊肿1例，腹腔出血1例，腹腔感染2例，死亡2例。
　结论　重视胰腺损伤的早期诊断，选择合理的手术方式及时手术，加强围手术期处理，可提高胰腺损伤的救治成功率。

Citation： 张青平,赵志勇,林武华. Diagnosis and Treatment of Blunt Pancreatic Trauma in 16 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(4): 393-394. doi: Copy

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7.	Valentino M, Serra C, Pavlica P, et al. Blunt abdominal trauma: diagnostic performance of contrast-enhanced US in children－initial experience [Ｊ]. Radiology, 2008; 246(3): 903-909.
8.	金崇田，杨永龙，王贵清, 等. 胰腺损伤17例诊断与治疗 [Ｊ]. 临床医学， 2005; 25(2)： 29-30.
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11.	蒋力生. 腹部实质脏器损伤非手术治疗的进展 [Ｊ]. 中国普外基础与临床杂志, 2003; 10(2): 165-167.
12.	Velmahos GC, Constantinou C, Kasotakis G. Safety of repair for severe duodenal injuries [Ｊ]. World J Surg, 2008; 32(1): 7-12.
13.	戴睿武, 何发群, 田伏洲. 损伤控制剖腹术治疗严重胰腺损伤19例 [Ｊ]. 中华创伤杂志， 2006; 22（5）： 327-330.
14.	Alexakis N, Sutton R, Neoptolemos JP. Surgical treatment of pancreatic fistula [Ｊ]. Dig Surg, 2004; 21(4): 262-274.
15.	彭淑牖，何小伟. 胰腺闭合性损伤救治原则和进展 [Ｊ]. 中华创伤杂志， 2005; 21（1）： 57-59.
16.	曹永宽, 张慧姿, 田伏洲, 等. 胰腺损伤的外科分级治疗与胰漏并发症的防治 [Ｊ]. 西南军医， 2008; 10（3）： 57-58.

1. 　Subramanian A, Dente CJ, Feliciano DV. The management of pancreatic trauma in the modern era [Ｊ]. Surg Clin North Am, 2007; 87(6): 1515-1532.
2. 　陈孝平. 外科学 [M]. 北京：人民卫生出版社, 2005： 540-541.
3. 　Moore EE, Cogbill TH, Malangoni MA, et al. Organ injury scaling, Ⅱ: Pancreas, duodenum, small bowel, colon, and rectum [Ｊ]. J Trauma, 1990; 30(11): 1427-1429.
4. 　Lin BC, Chen RJ, Fang JF, et al. Management of blunt major pancreatic injury [Ｊ]. J Trauma, 2004; 56(4): 774-778.
5. 　Wolf A, Bernhardt J, Patrzyk M, et al. The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma [Ｊ]. Surg Endosc, 2005; 19(5): 665-669.
6. 　Valentino M, Serra C, Zironi G, et al. Blunt abdominal trauma: emergency contrast-enhanced sonography for detection of solid organ injuries [Ｊ]. AJR Am J Roentgenol, 2006; 186(5): 1361-1367.
7. 　Valentino M, Serra C, Pavlica P, et al. Blunt abdominal trauma: diagnostic performance of contrast-enhanced US in children－initial experience [Ｊ]. Radiology, 2008; 246(3): 903-909.
8. 　金崇田，杨永龙，王贵清, 等. 胰腺损伤17例诊断与治疗 [Ｊ]. 临床医学， 2005; 25(2)： 29-30.
9. 　Bosboom D, Braam AW, Blickman JG, et al. The role of imaging studies in pancreatic injury due to blunt abdominal trauma in children [Ｊ]. Eur J Radiol, 2006; 59(1): 3-7.
10. 　肖玉根，杨清水. 手术治疗胰腺损伤17例报告 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(4): 455-456.
11. 　蒋力生. 腹部实质脏器损伤非手术治疗的进展 [Ｊ]. 中国普外基础与临床杂志, 2003; 10(2): 165-167.
12. 　Velmahos GC, Constantinou C, Kasotakis G. Safety of repair for severe duodenal injuries [Ｊ]. World J Surg, 2008; 32(1): 7-12.
13. 　戴睿武, 何发群, 田伏洲. 损伤控制剖腹术治疗严重胰腺损伤19例 [Ｊ]. 中华创伤杂志， 2006; 22（5）： 327-330.
14. 　Alexakis N, Sutton R, Neoptolemos JP. Surgical treatment of pancreatic fistula [Ｊ]. Dig Surg, 2004; 21(4): 262-274.
15. 　彭淑牖，何小伟. 胰腺闭合性损伤救治原则和进展 [Ｊ]. 中华创伤杂志， 2005; 21（1）： 57-59.
16. 　曹永宽, 张慧姿, 田伏洲, 等. 胰腺损伤的外科分级治疗与胰漏并发症的防治 [Ｊ]. 西南军医， 2008; 10（3）： 57-58.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of Blunt Pancreatic Trauma in 16 Cases

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