闭合性十二指肠损伤的诊断与治疗

Diagnosis and treatment of blunt duodenal injuries

目的探讨闭合性十二指肠损伤的早期诊断方法及治疗效果。方法回顾性分析经手术证实的23例闭合性十二指肠损伤的临床资料。结果术前早期确诊7例(30.4%),受伤部位主要为十二指肠第二段,共11例,占47.8%。全组死亡4例(17.3%),共发生各种并发症16例次。结论合理的手术方式是治疗十二指肠损伤的重要措施,早期手术和有效的十二指肠减压是影响预后的主要因素。

Objective To explore the managements of early diagnosis and suitable treatments for blunt duodenal injuries. Methods A retrospective study was made in 23 patients who sustained blunt duodenal injuries which were affirmed by operation. Results Early diagnosis were accomplished in 7 patients with a early diagnosis ratio of 30. 4%. The descending part of duodenum was the most common site of blunt injuries with a morbidity of 47. 8% （11/23）. Four patients died with a mortality of 17.3%. Sixteen complications of different kinds occurred. Conclusion Simple and reasonable surgical procedure plays an important role in management of duodenal trauma. Early operation and effective decompression of the duodenum are the major factors for prognosis.