鈍性胰臟創傷之臨床經驗

1986年至1990年，五年間共有22例鈍性胰臟創傷患者，在本院外科部接受手術治療，其中男性19例，女性3例，年齡分布2歲至58歲，平均31歲，追蹤期間由21個月至64個月，平均42個月，胰臟創傷嚴重度依美國創傷外科醫學會提出胰臟創傷標準度（pancreatic organ injury scale）分為五級分類法，第一級8例，第二級9例，第三級4例，第四級1例，無第五級患者。點併腹內臟器傷害，脾臟佔36.4％，肝臟佔27.3％，腎臟佔22.7％，結腸佔13.6％，小腸佔9.1％，及骨佔9.1％。外科手術方式12例作引流，7例作縫合及引流，3例無遠側胰臟切除術。4例死亡，死亡率為18.2％。9例發生併發症，其中胰瘻管3例，腸阻塞2例，腹內膿瘍1例，傷口感染1例，胰臟炎1，胰臟假性囊腫1例，併發症發生率為40.9％。

關鍵字

無資料

並列摘要

From 1986 to 1990, 22 patients with blunt pancreatic trauma were hospitalized and operated on in Kuang Tien General Hospital. Included were 19 males and 3 females with a mean age of 31 years (range: 2 to 58). The mean duration of the follow-up was 42 months. We classified the severity of pancreatic injury with the pancreatic organ injury scale which was published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A. A. S. T.) in 1990. According to the operative findings, the pancreatic injury of the 22 cases were classified as follows: grade Ⅰ8 case, grade Ⅱ 9 case, grade Ⅲ 4 cases, grade Ⅳ 1 case, and no grade Ⅴ pancreatic injuries. Among the patients, 12 cases were treated with drainage. Seven cases underwent repair and drainage. Three cases were treated with distal pancreatectomy. The mortality rate was 18.2%, and the morbidity rate 40.9%. The most frequent postoperative complications related to the pancreatic injury in the patients who survived the initial operation were pancreatic fistula (13.7%), small bowel obstruction (9.2%), intraabdominal abscesses (4.5%), wound infection (4.5%), pancreatitis (4.5%), and pseudocyst (4.5%).

並列關鍵字

blunt pancreatic trauma ； pancreatic organ injury scale ； abdominal trauma

國際替代計量

鈍性胰臟創傷之臨床經驗

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