十二指肠缝闭式旷置术临床应用研究

The Clinical Application of the Duodenum Closed Exclusion

目的:比较幽门旷置十二指肠憩室化各种术式,探讨十二指肠缝闭式旷置术的临床应用可能性及方法。方法:通过近12年32例十二指肠缝闭式旷置术患者的临床资料分析,对比其他手术方法,观察手术并发症、手术时间及术后恢复情况。结果:32例患者中2例出现胃瘫,经禁食、胃肠减压、肠内外营养等,分别与本次手术后第15天、21天恢复;1例切口感染,经换药痊愈;1例胃癌晚期患者出院后半年因恶性消耗衰竭而亡,其余患者恢复顺利,无近期与手术有关死亡病例。结论:十二指肠缝闭式旷置术术式简便、缝闭准确、并发症少、手术时间短、创伤小、更符合损伤控制原则,尤其适用于损伤严重、年老体弱及术中生命体征不平稳者。

Objective： To compare various duodenal diverticulization operation with pylorus exclusion, investigate the possibility of clinical application and method of the duodenum closed exclusion. Method： According to the clinical data of 32 cases with the duodenum closed exclusion during the past 4 years, to compare with others technique, observe the complication, operative time and postoperative recovery. Result： In the 32 cases, 2 cases recovered in the postoperative fifteenth day and twenty-first day which occured gastroplegia. 1 case occurred postoperative infection and recovered after change dressings, 1 case with advanced stage of gastric carcinoma died after half a year, because of cachexy. Others successfully recovered, and there was no dead case who was relevant to operation in the near future. Conclusion： The duodenum closed exclusion is convenient and accurate, the trauma is little and complication is few, the operative time is short, it is more coincident with the principle of damage control, especially applies to these cases who are aged and physically weak, injure severely and don＇ t have stable vital sign during operation.