闭合性十二指肠损伤的诊治

Diagnosis and treatment of closed injury of duodenum.

目的探讨闭合性十二指肠的损伤的早期诊断、手术时机、手术方法的选择及手术效果。方法对10年来收治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。结果术前确认3例,占37.5%;漏诊5例,占62.5%。8例均经手术治疗,术后发生并发症3例,占37.5%。治愈7例,占87.5%;死亡1例,占12.5%。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、早期手术及合理选择手术方式是治疗十二指肠损伤的重要措施。

Objective To investigate the early diagnosis, indications of operation, choice of operative procedures and effect of operation for closed injury of duodenum. Methods Clinical data of 8 cases of closed injury of duodenum in this hospital in recent 10 years were retrospectively analyzed. Results Three cases （37, 5% ） were diagnosed preoperatively, and 5 were misdlagnosed （62.5%）. All of these 8 patients were under- gone surgical treatment. 7 cases （87.5%） of them were cured, and 1 died （ 12.5% ）. Complications were seen in 3 （37.5%）, and duodenal fistula was the main complication. Conclusion The possibility of injury of duodenum should be aware of in patients with closed upper abdominal injury. Early diagnosis, early operation and rational choice of surgical procedures are very important in treatment of duodenal trauma.