Integration Of Traditional Chinese And Western Medicine In Treatment Of Pancreatic Trauma

Objective:To investigate the diagnosis and the therapeutic value with integration of traditional Chinese and Western medicine in the pancreatic trauma.Method:From February 2003 to February 2009,clinical data of the 28 cases with pancreatic trauma was analyzed retrospectively,about the diagnosis,the operative procedures,clinical effect and the treatment of complications.According to American Association for the Surgery of Trauma-Organ Injury Scale(AAST-OIS),include gradeⅠ8 cases,gradeⅡ9 cases,gradeⅢ5 cases,gradeⅣ3 cases and gradeⅤ3 cases.Debridement and peripancreatic drainage was performed in 17 cases.Pancreatic body and tail resection was 6 cases.Proximal pancreatic suture and ligation and distal pancreas with jejunum Roux-en-Y anastomosis was 3 case. Pancreatic head and duodenal repair plus duodenal diverticularization was 2 cases. Duodenopancreatectomy was 1 case.Injecting the promoting blood flow of Qingyitang to the gastrointestinal tract though the gastric tube or jejunum fistula after the operation aimed at removing the gastrointestinal and liver-gallbladder dampness-heat.It is of great benefit to the patient recovering from the injury. Result.Among the 28 cases,the accordance rate of ultrasound diagnosis was 50.0%(12/24),the accordance rate of the CT diagnosis 81.3%(13/16).The accordance rate of ultrasound diagnosis was lower than that of CT diagnosis obviously(p＜0.05). The positive rate of abdominal paracentesis was 57.1%(8/14).The positive rate of serum amylase preoperative was 83.3%(20/24).The positive rate of urine amylase preoperative was 66.7%(16/24).Serum amylase in the period of 6 hours to 48 hours after injury had higher lever than in 6 hours after injury,the positive rate was 60%(6/10).Among the 28 cases,24 cases were cured(88.9%,24/27),3 cases died(10.7%,3/28).Critical complications were occurred on 9 cases(32.1%,9/28).Conclusion:According to the history,abdominal signs,ultrasonography,CT scan and amylase examination,it contributes to the diagnosis of panereatic trauma.To observe the tendency of serum and urine amylase can provide the clue about pancreatic trauma.Ultrasound and CT should be adopt at first to the diagnosis of pancreatic trauma.Early diagnosis,grasping the opportunity of operation,the rational surgical procedures according to the grade of the pancreatic trauma and postoperative complications treated promptly are the key to improve the cure rate.Integration of traditional chinese and Western med should be used in the perioperative period to help the recovery of gastrointestinal function and the absorption of pancreatic exudation.And it is worth a further research.