闭合性胰腺损伤的临床分析(2)
3.3 并发症的预防
本组29例，有8例有并发症。胰瘘5例、假性囊肿2例、腹腔脓肿1例，并发症发生率27.6%。经引流及药物治疗，2～3月治愈。胰瘘是胰腺损伤手术后常见的并发症，我们认为以下几点预防有意义。①早期手术，彻底清创可避免胰液大量漏出，可及时清除胰腺周围胰液腐蚀的组织，减轻局部炎症的反应，对吻合口和创伤愈口有利。②冲洗腹腔、通畅有效的腹腔引流，放置多根双套管引流，术后大量盐水冲洗腹腔。③术后禁食和应用抑制胰液分泌的各种措施，有条件者行全静脉营养治疗。
[参考文献]
[1]LI pin，ZHOU Xu-kun，LI Zhong，et al.Dignosis and treatment of blunt pancreatic injury：report of 15cases[J].Chinese Journal of General surgery,2005,14(11):793-794.
[2]Moore EE,Cogbill TH,Malangom MA,et al.Organ injury scaling,Ⅱ:pancreas,duodenum,small bowel,colon,and rectum[J].J Trauma,1990,30(11):1427-1429.
[3]Edward L,Bradley Ⅲ,Peter R,et al.Diagnosis and initial management of blunt pancreatic trauma[J].Amsurg,1998,227(6):861.
[4]Adamson WT,Hebra A,Thomas PB,et al. Serum anylase and Lipase alone are not cost-effective screening methods for pediatric pancreatic trauma[J].J Pediatr Surg,2003,38(3):354-357.
[5]吴阶平,裘法祖,黄家驷.外科学[M].第6版.北京：人民卫生出版社,2000.963-965.
[6]张友磊,张玉霞,袁克文,等.胰腺损伤的外科处理(附24例报告)[J].创伤外科杂志,2002,4(3):142-144.
[7]LIAO Nian-Sheng,ZHAO Xu,SHIJing-Seng,et al.Experience of diaganosis and treatment of pancreatic injury[J].Journal of Hepatobiliary Surgery, 2005, 13(1):45-46.
(收稿日期：2007-11-01), http://www.100md.com(余思忠 易石坚 孙长立 刘兆云)
本组29例，有8例有并发症。胰瘘5例、假性囊肿2例、腹腔脓肿1例，并发症发生率27.6%。经引流及药物治疗，2～3月治愈。胰瘘是胰腺损伤手术后常见的并发症，我们认为以下几点预防有意义。①早期手术，彻底清创可避免胰液大量漏出，可及时清除胰腺周围胰液腐蚀的组织，减轻局部炎症的反应，对吻合口和创伤愈口有利。②冲洗腹腔、通畅有效的腹腔引流，放置多根双套管引流，术后大量盐水冲洗腹腔。③术后禁食和应用抑制胰液分泌的各种措施，有条件者行全静脉营养治疗。
[参考文献]
[1]LI pin，ZHOU Xu-kun，LI Zhong，et al.Dignosis and treatment of blunt pancreatic injury：report of 15cases[J].Chinese Journal of General surgery,2005,14(11):793-794.
[2]Moore EE,Cogbill TH,Malangom MA,et al.Organ injury scaling,Ⅱ:pancreas,duodenum,small bowel,colon,and rectum[J].J Trauma,1990,30(11):1427-1429.
[3]Edward L,Bradley Ⅲ,Peter R,et al.Diagnosis and initial management of blunt pancreatic trauma[J].Amsurg,1998,227(6):861.
[4]Adamson WT,Hebra A,Thomas PB,et al. Serum anylase and Lipase alone are not cost-effective screening methods for pediatric pancreatic trauma[J].J Pediatr Surg,2003,38(3):354-357.
[5]吴阶平,裘法祖,黄家驷.外科学[M].第6版.北京：人民卫生出版社,2000.963-965.
[6]张友磊,张玉霞,袁克文,等.胰腺损伤的外科处理(附24例报告)[J].创伤外科杂志,2002,4(3):142-144.
[7]LIAO Nian-Sheng,ZHAO Xu,SHIJing-Seng,et al.Experience of diaganosis and treatment of pancreatic injury[J].Journal of Hepatobiliary Surgery, 2005, 13(1):45-46.
(收稿日期：2007-11-01), http://www.100md.com(余思忠 易石坚 孙长立 刘兆云)