闭合性十二指肠损伤68例临床诊治研究

Clinical Diagnosis and Treatment of 68 Cases of Closed Duodenal Injury

目的针对闭合性十二指肠损伤的临床特点、诊治方法及术后护理等情况进行探究。方法回顾性分析2015年1月至2019年1月在重庆市合川区人民医院确诊并进行手术治疗的68例闭合性十二指肠损伤患者的临床资料。采用CT、X线和B超检查对患者症状进行早期诊断,采用合适的手术方式对闭合性十二指肠损伤患者进行手术治疗,包括十二指肠修补手术(胃肠减压以及胃、空肠造瘘)、十二指肠壁血肿清除术、十二指肠胆管空肠(Roux-Y)吻合术、十二指肠损伤肠段切除术、十二指肠憩室化术以及肝破裂修补术,术后对患者给予合适的围手术期护理。结果本课题中的68例闭合性十二指肠损伤患者中有65例患者完全治愈,治愈率达95.59%;有3例患者在术后及围手术期护理过程中出现严重并发症最终导致多器官功能衰竭引起的死亡,死亡率为4.41%。结论采用合适的早期诊断方式、及时且合理的手术治疗和科学的围手术期护理模式能够有效提高闭合性十二指肠患者的治愈率,减少并发症及死亡情况的发生。

Objective To explore the clinical characteristics,diagnosis and treatment methods and postoperative nursing of closed duodenal injury.Methods Retrospective analysis was performed on the clinical data of 68 patients with closed duodenal injury diagnosed and treated by surgery in Hechuan District People's Hospital of Chongqing from January 2015 to January 2019.CT,X-ray,and ultrasound examination of symptoms in patients with early diagnosis and adopt suitable surgical procedure for surgical treatment in patients with closed duodenum damage,including duodenal repair surgery(gastrointestinal decompression,and stomach,jejunum colostomy)for removal of hematoma and duodenum jejunum and duodenum wall Roux-Y anastomosis,bowel resection duodenum injury,duodenal diverticulum and liver rupture repair,postoperative to give proper perioperative nursing to the patients.Results Among the 68 cases of closed duodenal injury,65 cases were completely cured,the cure rate was 95.59%;there were 3 cases of severe complications in the process of postoperative and perioperative nursing,which eventually led to the death caused by multiple organ failure,the mortality rate was 4.41%.Conclusion Appropriate early diagnosis,timely and reasonable surgical treatment and scientific perioperative nursing mode can effectively improve the cure rate of patients with closed duodenum and reduce the occurrence of complications and death.