创伤性十二指肠破裂24例治疗体会

Diagnosis and treatment of 24 cases traumatic rupture of duodenum

目的 :探讨创伤性十二指肠破裂的死亡原因及破裂口修补后易再破的原因。方法 :对我院近十二年来所作的 2 4例十二指肠破裂手术回顾性分析。结果 :全组病例中 ,治愈 18例 ,死亡 6例。死因 :①合并伤过重 ;②单纯修补术后破裂口渗漏 ,继发腹腔感染 ;③多处破裂被遗留造成高位肠瘘。结论 :对创伤性十二指肠破裂患者 ,①应首先处理重要合并伤 ;②对十二指肠破裂应详细检查防止遗留多发性破裂伤 ;③十二指肠旷置减压术能有效降低十二指肠内压 ,减少胰液和胆汁分泌 ,提高破裂口的愈合率。

Objective: To improve the diagnosis and treatment of traumatic rupture of duodenum Methods: clinical data of 24 patients with traumatic duodenal rupture treated in these 12 years were studied retrospectively. Results: Of the 24 patients,18 patients were cured successfully,and 6 died of severe mutiple organ injure,duodenal fistula and intra-abdominal abscess. Conclusion: Correct diagnosis and treatment are essential for traumatic duodenal rupture ,cogbill′Sor modified cogbill′s techniques are practical in the operation management.