创伤性胰腺炎的诊断与治疗
发布时间：2019-07-01 09:53
【摘要】：目的总结创伤性胰腺炎(TP)的诊治经验。方法回顾性分析2013年10月至2015年10月哈尔滨医科大学附属第一医院诊治的13例TP患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男9例,女4例;年龄28~53岁,中位年龄39岁;均有明确外伤史,主要为交通伤、挤压伤。观察患者的诊断、治疗及并发症发生情况。结果本组患者胰腺损伤以Ⅱ、Ⅲ级为主,胰头部损伤5例,胰颈、体尾部损伤8例;确诊TP时间集中在外伤后2~5 d。1例患者行非手术治疗;12例行微创手术治疗,其中行经皮穿刺置管引流术治疗8例,行内镜下放置胰管支架1例,行内镜下坏死组织清除4例;8例行开腹手术治疗。12例发生并发症,腹腔或腹膜后感染9例,行微创手术治疗,其中6例合并严重多脏器损伤,行再次手术;结肠瘘5例,其中3例肠瘘与腹腔感染灶相通,行瘘口近端肠道造口、二期关闭瘘口。本组患者中位住院时间为57(17~134)d,均经治疗后痊愈出院。结论 TP起病隐匿,进展迅速,早期诊断困难,应根据患者的具体情况选择个体化治疗方案。
[Abstract]:Objective to summarize the experience of diagnosis and treatment of traumatic pancreatitis (TP). Methods the clinical data of 13 patients with TP diagnosed and treated in the first affiliated Hospital of Harbin Medical University from October 2013 to October 2015 were analyzed retrospectively. All patients signed informed consent forms, in accordance with the provisions of medical ethics. There were 9 males and 4 females, 28 years old and 53 years old, and the median age was 39 years old. All of them had a definite history of trauma, mainly traffic injury and crush injury. The diagnosis, treatment and complications of the patients were observed. Results there were 5 cases of pancreatic head injury, 8 cases of pancreatic neck and body and tail injury, 12 cases of minimally invasive surgery, 8 cases of pancreatic duct stent placement and 4 cases of endoscopic necrotic tissue removal, and 12 cases of pancreatic injury were treated with minimally invasive surgery, including 8 cases of pancreatic head injury, 8 cases of pancreatic neck injury, 8 cases of pancreatic tail injury, 8 cases of pancreatic head injury, 8 cases of pancreatic neck injury, 8 cases of pancreatic tail injury, 8 cases of pancreatic head injury, 8 cases of pancreatic neck injury, 8 cases of pancreatic tail injury. Complications occurred in 12 cases, abdominal or retroperitoneal infection in 9 cases, minimally invasive surgery was performed in 6 cases with severe multiple organ injury, and colon fistula was performed in 5 cases, including 3 cases of intestinal fistula connected with abdominal infection, proximal enterostomy and secondary closure of fistula. The median hospitalization time of the patients was 57 (17 鈮，
本文编号：2508381
[Abstract]:Objective to summarize the experience of diagnosis and treatment of traumatic pancreatitis (TP). Methods the clinical data of 13 patients with TP diagnosed and treated in the first affiliated Hospital of Harbin Medical University from October 2013 to October 2015 were analyzed retrospectively. All patients signed informed consent forms, in accordance with the provisions of medical ethics. There were 9 males and 4 females, 28 years old and 53 years old, and the median age was 39 years old. All of them had a definite history of trauma, mainly traffic injury and crush injury. The diagnosis, treatment and complications of the patients were observed. Results there were 5 cases of pancreatic head injury, 8 cases of pancreatic neck and body and tail injury, 12 cases of minimally invasive surgery, 8 cases of pancreatic duct stent placement and 4 cases of endoscopic necrotic tissue removal, and 12 cases of pancreatic injury were treated with minimally invasive surgery, including 8 cases of pancreatic head injury, 8 cases of pancreatic neck injury, 8 cases of pancreatic tail injury, 8 cases of pancreatic head injury, 8 cases of pancreatic neck injury, 8 cases of pancreatic tail injury, 8 cases of pancreatic head injury, 8 cases of pancreatic neck injury, 8 cases of pancreatic tail injury. Complications occurred in 12 cases, abdominal or retroperitoneal infection in 9 cases, minimally invasive surgery was performed in 6 cases with severe multiple organ injury, and colon fistula was performed in 5 cases, including 3 cases of intestinal fistula connected with abdominal infection, proximal enterostomy and secondary closure of fistula. The median hospitalization time of the patients was 57 (17 鈮，
本文编号：2508381
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