吴祯乾 沈容荣 阎钧 汪昱

    摘 要 胰腺损伤多继发于腹部创伤，病情重且多合并有其他器官的同时性损伤。因其缺乏特异性体征，早期诊断困难，容易发生漏诊和误诊，如果不及时处理可继发更广泛的损伤和严重并发症，病死率较高。腹部增强CT检查对诊断胰腺损伤十分重要和必要，但对胰管损伤缺乏特异性，而磁共振胰胆管造影(MRCP)或内镜逆行胰胆管造影(ERCP)对术前评估损伤分级、判断胰管损伤部位及程度更有价值。胰腺损伤的手术较为复杂，术中应注意对胰腺及十二指肠的仔细探查，以免遗漏潜在的胰腺损伤，手术方式以胰腺损伤分级为指导，根据不同的严重性采取相应的手术方式。对于存在血流动力学不稳定的重症患者应采取以挽救生命为首要目的损伤控制性手术。

    关键词 胰腺损伤；胰腺损伤分级；胰管损伤；诊断；治疗

    中图分类号：R576 文献标志码：A 文章编号：1006-1533(2021)18-0003-05

    Clinical diagnosis and treatment of pancreatic trauma

    WU Zhenqian， SHEN Rongrong， YAN Jun， WANG Yu

    (Department of General Surgery， the Sixth Peoples Hospital Affiliated to Shanghai Jiao Tong University， Shanghai 200233， China)

    ABSTRACT Pancreatic trauma is secondary to abdominal trauma， which is serious and always accompanied by simultaneous injury of other viscera. Due to the lack of specific signs， early diagnosis is difficult， and misdiagnosis and missed diagnosis are prone to occur. If not treated in time ......