中国实用外科杂志

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创伤性胰腺炎研究进展

程春东白雪巍,孙    备   

  1. 哈尔滨医科大学附属第一医院胰胆外科,黑龙江哈尔滨150001
  • 出版日期:2016-01-01 发布日期:2015-12-31

  • Online:2016-01-01 Published:2015-12-31

摘要:

创伤性胰腺炎(traumatic pancreatitis,TP)是继发于胰腺外伤,主要表现为胰腺急性炎症反应、难以控制的腹腔感染和其他复杂并发症。近年来,因交通及建筑事故等造成的闭合性腹部外伤病人显著增加,胰腺损伤及TP发病率明显升高。TP早期误诊率高、治疗棘手、病情进展快、并发症多、病死率高。TP的自然病程可分为创伤期、感染期和并发症期三个阶段。其治疗的关键点在于:创伤期,控制病人多器官功能损伤和全身炎症反应;感染期,正确把握手术时机控制感染;并发症期,采取恰当的措施处理并发症。目前,对于TP仍有一些问题亟待解决。

关键词: 创伤性胰腺炎, 创伤递进式分阶段处理, 多学科协作

Abstract:

Development of diagnosis and treatment in traumatic pancreatitis        CHENG Chun-dong,BAI Xue-wei,SUN Bei. Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Corresponding author: SUN Bei. E-mail: sunbei70@tom.com
Abstract    Traumatic pancreatitis (TP) may occur secondary to pancreatic trauma. The main clinical manifestations of TP present with acute inflammation responses, uncontrolled intra-abdominal infection and other complications. Recently, numbers of traffic and construction accidents increase the occurrence of closed abdomen injury, which results in a higher morbidity of pancreatic trauma and TP. TP is characterized by higher misdiagnosis rate in the early phase, difficult to manage, highly aggressive process, severe complications and high mortality. The natural stage of TP can be divided into three parts: trauma stage, infection stage and complication stage. The main points of treatment for TP are the following:Firstly, management of multiple organ failure and systemic inflammatory response in trauma stage; Secondly, right choice of operative timing to control intra-abdominal infection in infection stage; Effective measures to deal with complications in complication stage. It will be of great importance for the treatment of TP, meanwhile there are still some issues remained to be further elucidated.

Key words: traumatic pancreatitis, step-up approach, multidisciplinary team