15例外伤性十二指肠损伤的临床分析

Clinical analysis of 15 cases with traumatic duodenal injuries

目的探讨十二指肠损伤的合理诊治措施及影响预后的因素。方法对1996年1月～2007年1月该院急救中心外科收治的15例外伤性十二指肠损伤病例的临床资料进行回顾性分析。分析十二指肠损伤早期临床特征、处理方法及其造成死亡的原因。结果15例均进行手术治疗,治愈13例(86.7%),死亡2例(13.3%),所有病例均经术中探查而确诊,术前漏诊3例,术中漏诊1例。术后十二指肠瘘3例(20.0%)。结论早期手术治疗是治疗十二指肠损伤的重要措施,选择合适的术式是影响预后的重要因素,导致患者死亡的主要原因是误诊和漏诊。

[Objective] To investigate the reasenable diagnosis and treatment measure for traumatic duodenal injuries and the factors influencing its prognosis [Methods] 15 cases of traumatic duodenal injuries were collected from January 1996 to January 2007 in the Surgical Department of our emergency center, and the early clinical characters, the treatment and cause of deaths were analyzed retrospectively. [Results] All the 15 cases underwent surgical treatment, 13 cases （86.7%） were cured, and 2 cases died （13.3%）. All the cases got diagnosis in operation, 3 got missed diagnosis before operation and 1 case got missed diagnosis in operation. 3 cases （20%） had postoperative duodenal fistula. [Conclusion] Early surgical treatment is very important for duodenal trauma and selecting proper surgical management is the major prognostic factor, the major causes of death are misdiagnosis and missed diagnosis.