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急诊胰腺损伤患者的多层螺旋CT表现及诊断价值研究

作者:李仁和

所属单位:湖北省鄂州二医院(湖北 鄂州 436000)

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摘要

目的 分析急诊胰腺损伤患者多 层螺旋CT表现及其诊断价值。方法 回顾 性分析2012年5月~2015年5月于我院经 手术及临床随访证实为急诊胰腺损伤的 26例患者的临床资料,所有患者入院后 均接受多层螺旋CT扫描,且影像学资料 完整,总结急诊胰腺损伤患者多层螺旋 CT特点,分析螺旋CT在急诊胰腺损伤患 者诊断中的应用价值。结果 本组26例胰 腺损伤患者,初诊共明确诊断21例,诊 断准确性为80.77%。其中浅表性组织损 伤16例,其中11例合并严重损伤,且均 经手术证实,其中腺体部假性囊肿并出 血2例,胰尾裂伤2例,胰腺表层局灶性 或弥漫性出血7例。结论 采用多层螺旋 CT检查,可提高急诊胰腺损伤患者诊断 符合度,为治疗方式的确立提供参照, 但同样有其局限性,需配合随诊及CT复 查。

Objective To analyze the manifestations and diagnostic value of multi-slice spiral CT in patients with emergency pancreatic trauma. Methods The clinical data of 26 patients with emergency pancreatic trauma confirmed by operation and clinical follow-up in our hospital from May 2012 to May 2015 were retrospectively analyzed. After admission, all patients underwent multi-slice spiral CT scanning, and the imaging data were complete. The features of multi-slice spiral CT in patients with emergency pancreatic trauma were summarized. The application value of spiral CT in the diagnosis of patients with emergency pancreatic trauma was analyzed. Results In the group of 26 patients with pancreatic trauma, 21 cases were newly diagnosed and the diagnostic accuracy was 80.77%. 16 cases were with superficial tissue injury, including 11 cases with severe injury, and all of them were confirmed by operation. There were 2 cases with pancreatic false cysts, 2 cases with pancreatic tail laceration and 7 cases with pancreatic superficial focal or diffuse hemorrhage. Conclusion To adopt multi-slice spiral CT examination can improve the conformity in the diagnosis of patients with emergency pancreatic trauma and provide a reference for the establishment of treatment, but it also has limitations, which needs to cooperate with follow-up and CT reexamination.

【关键词】胰腺损伤;多层螺旋CT;特 点;诊断

【中图分类号】R445.3;R576

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.03.029

前言

胰腺位于人体上腹部腹膜后端,位置较深,活动度小,四周有其 他器官保护及掩盖,在腹部外伤时其受损发生率一般较低,占腹部闭 合损伤的3%左右[1]。胰腺损伤通常合并其他脏器官损伤,临床症状不 明显,有其隐蔽性,且部分症状出现迟缓,诊断困难,较易造成误 诊及漏诊,且患者大多病情危重,并发症发生率高,且死亡率高[2]。 同时近年来,随着工伤及交通事故的增加,胰腺损伤发生率也略有上 升。而近年来较多研究者表示,多层螺旋CT对急诊胰腺损伤有其较高 的优势,且敏感性高[3]。基于此,为分析急诊胰腺损伤患者的多层螺 旋CT表现,我院对收治的26例急诊胰腺损伤患者的临床资料展开了回 顾性分析,现报道如下。