闭合性十二指肠损伤的诊治体会

Diagnosis and treatment of closed injury of the duodenum

目的 探讨闭合性十二指肠损伤的早期诊断、手术时机、手术方法的选择及手术效果。方法 对近 11年来收治的 3 8例闭合性十二指肠损伤病例的临床资料进行回顾性分析。结果 术前确诊 3 0例 (78.9% ) ,误诊 8例 (2 1.1% )。 3 8例均经手术治疗 ,术后发生并发症 9例 (2 3 .7% ) ,十二指肠瘘是主要的并发症。治愈 3 6例 (94.7% ) ,死亡 2例 (5 .3 % )。结论 对上腹部闭合性损伤患者应警惕存在十二指肠损伤的可能 ,早期诊断。

Objective To investigate the early diagnosis, indications of operation, choice of operative procedure and effect of operation of closed injury of the duodenum . Methods The clinical data of 38 cases of closed injury of the duodenum treated in recent 11 years were retrospectively analysed . Results Thirty cases(78.9%) were diagnosed preoperatively, and 8 were misdiagnosed(21.1%). All of the 38 patients underwent surgical treatment. 36 cases(94.7%) were cured ,and 2 died(5.3%). Complications occurred in 9(23.7%) .Duodenal fistula was the main complication .Conclusions One must be alert to the possibility of injury of the duodenum in patients with closed upper abdominal injury. Early diagnosis, early operation and rational choice of surgical procedure are very important for the treatment of duodenal trauma.