损伤控制性手术理论在严重十二指肠损伤诊治中的应用实践

The application of damage control theory in the diagnosis and treatment of severe duodenal injury

目的:对一种符合损伤控制原则,针对严重十二指肠损伤的手术方式进行临床探讨。方法:回顾性分析15例严重十二指肠损伤病人,采用三段一体式十字槽管简化术式的临床资料。结果:15例患者中,13例治愈,治愈率为87%,2例多器官严重创伤患者因继发多器官功能衰竭死亡,死亡率13%。术后并发十二指肠瘘2例,胰瘘1例,均通过有效的内、外引流治愈,无继发于十二指肠瘘的死亡病例。结论:严重十二指肠损伤患者采用三段一体式十字槽管行十二指肠内减压,配合有效外引流的手术方式简便、治愈率高,符合损伤控制原则,可在临床中推广。

Objective： To investigate the surgical procedures of severe duodenal injury,conform to the damage control principle. Method： Fifteen cases of severe duodenal injury patients in our hospital from Jan 2009 to Jul 2017 were selected,all used a three-stage cross-channel tube in surgery,retrospective analyse these clinical data. Results： In these 15 cases of patients,13 cases cured,cure rate was 87 percent,2 cases of secere multiple organ trauma died of secondary multi organ failure,death rate was 13 percent. 2 cases of duodenal leakage and one case of pancreatic leakage post operation,all were cured by effective internal and external drainage,no death case in subsequent of duodenal leakage. Conclusion： Apply a three stage cross channel tube in duodenal internal decompressin,for severe duodenal injury patients,with effective external drainage,is simple and cure rate is high. It conforms to damage control principle and can be applied clinically.