【摘要】：目的總結(jié)創(chuàng)傷性胰腺炎(TP)的診治經(jīng)驗。方法回顧性分析2013年10月至2015年10月哈爾濱醫(yī)科大學(xué)附屬第一醫(yī)院診治的13例TP患者臨床資料�；颊呔炇鹬橥鈺�,符合醫(yī)學(xué)倫理學(xué)規(guī)定。其中男9例,女4例;年齡28~53歲,中位年齡39歲;均有明確外傷史,主要為交通傷、擠壓傷。觀察患者的診斷、治療及并發(fā)癥發(fā)生情況。結(jié)果本組患者胰腺損傷以Ⅱ、Ⅲ級為主,胰頭部損傷5例,胰頸、體尾部損傷8例;確診TP時間集中在外傷后2~5 d。1例患者行非手術(shù)治療;12例行微創(chuàng)手術(shù)治療,其中行經(jīng)皮穿刺置管引流術(shù)治療8例,行內(nèi)鏡下放置胰管支架1例,行內(nèi)鏡下壞死組織清除4例;8例行開腹手術(shù)治療。12例發(fā)生并發(fā)癥,腹腔或腹膜后感染9例,行微創(chuàng)手術(shù)治療,其中6例合并嚴(yán)重多臟器損傷,行再次手術(shù);結(jié)腸瘺5例,其中3例腸瘺與腹腔感染灶相通,行瘺口近端腸道造口、二期關(guān)閉瘺口。本組患者中位住院時間為57(17~134)d,均經(jīng)治療后痊愈出院。結(jié)論 TP起病隱匿,進(jìn)展迅速,早期診斷困難,應(yīng)根據(jù)患者的具體情況選擇個體化治療方案。
[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，

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