创伤性胰腺炎的诊断与治疗_11例临床分析及文献复习

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1、肝胆外科杂志2012年10月第20卷第5期JournalofHepatobiliarySurgery，Vol，20，No．5，Oct．2012335创伤性胰腺炎的诊断与治疗———11例临床分析及文献复习孙昀，耿小平【摘要】目的总结创伤性胰腺炎的分类，特点，诊断与治疗方法。方法回顾性分析2009年01月～2012年07月安徽医科大学第二附属医院重症医学科收治的11例创伤性胰腺炎病例诊治经过，将创伤性胰腺炎分为非手术创伤性和手术创伤性二类，分别总结二类创伤性胰腺炎的发病机制、临床特点及诊治要点并复习国内外相关文献。结果11例

2、创伤性胰腺炎中非手术相关性8例，手术相关性3例;针对胰腺炎行手术治疗2例，保守治疗9例;11例中死亡2例，好转2例，治愈7例。结论创伤性胰腺炎早期诊断有赖于对胰腺可能致伤因素的仔细分析及对患者病情变化动态连续的观察;多数创伤性胰腺炎可通过保守治疗治愈。【关键词】创伤性胰腺炎;诊断;治疗【中图分类号】R658【文献标识码】A【文章编号】1006-4761(2012)05-0335-05THEDIAGNOSISANDTREATMENTOFTRAUMATICPANCREATITIS:REPORTOF11CASESANDREVI

3、EWOFTHELITERATURE(SUNYun，GENGXiao-ping．DepartmentofICU，theSecondAffiliatedHospitaltoAnhuiMedicalUniversity，Hefei230601，China)【Abstract】ObjectiveTosummarizetheclassificationandcharacteristicoftraumaticpancreatitis，theninvestigatethemeth-odsofdiagnosisandtreatmentf

4、orthisdisease．MethodsElevenpatientswithtraumaticpancreatitisweretreatedinintensivecareunitofthesecondaffiliatedhospitaltoAnhuimedicaluniversitybetweenJanuary2009toJuly2012，Theirmedicalrecordsanddatawereretrospectivelyreviewed．Weclassifiedthisdiseasetononsurgicalt

5、raumaticpancreatitisandsurgicaltraumaticpancreatitis，andthene-valuatetheetiologies，clinicalpresentations，managementandoutcomeofthisdisease．Resultsthreeofthepatientsweresecondarytoabdominalsurgeryandeightwereduetoaccidentorcrashfromhigh．Thediagnosisoftenpatientswa

6、sbasedonCTscanfindings，onlyonewasbyultrasonicinspectiononbedsidebecauseofhisseveresituation．Toaimatpancreatitis，thereareninepatientsweretreatmentbynonoperativemanagement，theothertwopatientswereplaceddrainagetubeoncavitaspelvisandretroperitonealaroundpancreasbylap

7、arotomy．Twocasesdied，twocasesimproved，sevencasescured．ConclusionsTheetiologiesoftraumaticpancreatitisarediverse．Tohaveanintimateknowledgeofthecharacteroftheinjury，Continuousobservethechangeofclinicalpresentationandra-diologicalinformationofpatients，canbehelpfulin

8、diagnosedandperformedtherapeuticmeasurestimelyandproperly．Mosttraumaticpancreatitiscanbetreatedconservatively，withsurgicalinterventionbeinglimitedtohigh-graded