胃及空肠造瘘治疗十二指肠损伤的体会(附12例报告)

Experience of stomach and jejunum ostomy in duodenum injury treatment (12 cases report)

目的探讨胃及空肠造瘘在十二指肠损伤中的作用。方法对该院自1996年11月￣2002年11月共收治车祸伤致十二指肠损伤病人12例进行回顾性分析,全部病人除常规的综合治疗外,均进行胃造瘘十二指肠引流、减压,空肠造瘘肠内营养及消化液的转流。结果12例病人9例治愈,3例死亡。其中1例因门静脉破裂,肝破裂无法控制的大出血死亡;1例并发ARDS死亡;1例因吻合口漏、出血、不全性肠梗阻导致全身多器官功能衰竭死亡。结论胃及空肠造瘘减少了十二指肠漏的发生率,缩短了住院时间,减少了住院费用,收到了满意的临床效果。

[Objective] To explore the role of the stomach and jejunum ostomy in duodenum injury treatment. [Methods] Retrospective analysis of 12 cases duodenum injury patients caused by traffic accident during 11/1996 to 11/2002 in our hospital. Besides of comprehensive -treatment, all the patients were performed stomach ostomy to duodenum drainage and decompression and jejunum ostomy to enteral nutrition and digestive juice translocation. [Results] Three patients were died in 12 cases, 9 were cured. In dead patients, one was owing to portal vein rupture and hepatic rupture which caused uncontrollable massive hemorrhage, one died of ARDS and one died of multiple organ failure which was led by stoma leak, hemorrhage and incomplete intestinal obstruction. [Conclusion] The stomach and jejunum ostomy can decrease incident rate of duodenum leak after its injury, shorten length of stay in hospital and cut down treatment costs. It also has a satisfactory treatment effect.