十二指肠损伤的诊断和治疗

Etiology of duodenal trauma and its diagnosis and treatment

目的探讨十二指肠损伤因素，提高其诊断和治疗水平。方法回顾性分析1968年3月至2007年9月收治的十二指肠损伤患者28例，对其受伤因素、诊断和治疗进行分析。结果闭合性损伤占78．6％（22／28），开放性损伤占21．4％（6／28），合并伤占89．3％（25／28）；受伤部位以降部为多占46-4％（13／28），水平部次之占21．4％（6／28）；手术后并发症发生率为28．6％（8／28），病死率为3．6％（1／28），治愈率为96．4%（27／28）。结论十二指肠损伤在我国以闭合性损伤多见。重视术前检查、术中探查及选择恰当术式，加强术后管理，可减少死亡和并发症的发生。

Objective To analyze the etiology of duodenal trauma and improve the result of its diagnosis and treatment. Methods The data of 28 cases with duodenal trauma during March 1968 to September 2007 was analyzed retrospectively. Results Twenty-two （78.6%） patients had blunt injuries. The rate of duodenal trauma and associated injuries was 21.4% （6/28）and 89.3 % （25/28） respectively. The easiest injury part on the descending part constituting was 46.4 % （ 13/28 ）, the secondary on the horizontal part constituting was 21.4% （6/28）.The postoperative complication rate was 28.6% （8/28）, the mortality rate was 3.6% （1/28）, and the cure rate was 96.4% （27/28）. Conclusions The incidence of blunt injuries is high compared with other kinds of duodenal trauma in China. It suggests that the early diagnosis, exploration proper surgical management, and intensive postoperative care are emphasized to reduce the mortality and complication rate.