十二指肠损伤的诊断和治疗

Diagnosis and treatment of duodenal injury

目的探讨十二指肠损伤的诊治特点。方法回顾性分析20例十二指肠损伤的临床资料。结果术前确诊15例,误诊5例,误诊率25%。本组全部经手术治疗痊愈,其中2例出现十二指肠瘘和腹腔脓肿,经再次手术后治愈。结论十二指肠损伤早期诊断、及时正确手术是极其重要的。有效地十二指肠引流、空肠造瘘、肠内营养有利于十二指肠损伤愈合。

Objective To study the mechanism of duodenal injury and improve its diagnosis and treatment.Methods Clinical materials of 20 cases of duodenal injury were analyzed retrospectively. Results Most of the cases were complicated with additional injuries in other organs. Closed injury was mostly seen. All patients were treated by operation and survived. Duodenalfistula and abdominal abscess occurred in two patient who were cured after the reoperation. Conclusions Early diagnosis and proper treatment in time are most important. An effective duodenal drainage and enteral nutrition through jejunostomy are beneficial to healing the injury.