闭合性十二指肠损伤23例分析

Analysis on 23 Cases of Closed Trauma of Duodenum

目的探讨闭合性十二指肠损伤的诊断。方法对23例闭合性十二指肠损伤诊断与治疗方法。结果根据腹部纯性损伤，右季肋部或背部。肾区疼痛并逐渐加重，诊断性腹部穿刺（DPL）加腹部X光片，B超检查20例，DPL加cT检查2例，MRI检查1例，手术前确诊16例（69．5％），漏诊2例（8．6％），并发症2例（8．6％），治愈22例（95．6％），死亡1例（4．3％）。结论闭合性十二指肠损伤，多为复合伤，病性复杂，且严重，应仔细检查，早期诊断，早治疗是救治成功的关键。

Objective To explore the diagnosis and treatment of closed trauma of duodenum. Methods Diagnosis and treatment methods on 13 cases of closed truma of duodenum. Results According to the abdom- inal passivity injury, the pain of hypochondrium or back beside renal region was aggravated gradually. 20 cases were examined with DPL added with abdomen X ray and B ultrasound. 2 cases were done With DPL added with CT. MRI examination was given to 1 case. 16 cases were diagnosed before opreation （69. 5% ）, 2 cases had missed（8. 6% ）. 2 cases occurred to complications （ 8.6% ）. 22eases were healed （95.6%）. 1 case died （4. 3 % ）. Conchlsion The closed trauma of duodenum, belonged to combined injury. The illness conditions were complex and severe. It should be examined carefully and the early diagnosis and treatment were the key points to get successful cure.