十二指肠损伤的特点及其诊断和治疗

The clinical features of duodenal trauma and its diagnosis and treatment

目的提高十二指肠损伤的外科治疗水平。方法回顾性总结我院１９７３～１９９７年间收治的十二指肠损伤３４例临床经验。结果合并其他腹部脏器损伤７９％（２７／３４），单纯十二指肠损伤２１％（７／３４）。损伤部位以十二指肠降部为多见占５９％（２０／３４），水平部次之占２４％（８／３４）。术中漏诊率为１５％（５／３４）；手术后并发症发生率为３５％（１２／３４）；病死率为１５％（５／３４）。结论掌握十二指肠损伤的特点，注重早期诊断、早期手术，加强术中探查，掌握好探查指征，根据伤情选择合理、恰当的术式，加强术后管理，可提高治愈率。

Objective To improve the result of surgical treatmemt in patients suffering from duodenal injuries. Methods Clinical experience was summerized on 34 cases of duodenal damage hospitalized at our hospital during recent 25 years. Results Twenty seven (79%) cases were complicated by additional other intraabdominal organ injuries.The trauma was mostly often seen on the decending part constituting 59% (20/34),and on the horizontal part constituting 24% (8/34).The rate of failure to diagnose intraoperatively is 15% (5/34);The postoperative complication rate is 35% (12/34).The mortality rate is 15% (5/34).Conclusion Better understanding of the clinical features of the duodenal trauma,early diagnosis and exploration,careful intraoperative inspection,proper surgical management and intensive postoperative care all contribute to the better prognosis in patients with duodenal trauma.