十二指肠损伤的诊治体会(附42例分析)

Diagnosis and treatment of duodenal injury

目的 :提高十二指肠损伤的诊治水平。方法 :回顾性分析 1990年 1月至 2 0 0 1年 12月收治的 4 2例十二指肠损伤的患者诊治体会。结果 :十二指肠损伤 4 2例中 ,行剖腹探查 36例 ,死亡 5例 ;行保守治疗 6例 ,死亡 2例。结论 :十二指肠损伤救治工作中应遵循抢救诊断和治疗并重的原则。伤口探查、腹腔穿刺、超声检查、腹部平片对诊断有重要参考价值。有手术指征应立即急诊手术 ,无手术指征的病人应留院或住院观察 。

Objective:To improve the level of diagnosis and treatment of the injury in the duodenum. Methods:Forty two cases which were treated from Jan. 1990 to Dec. 2001 were reviewed.Results:Among 36 cases who underwent the exploration,5 cases died.Among 6 cases who underwent conservative treatment,2 cases died.Conclusion:The condition of the injury in the duodenum is very complicated,it is easy to be misdiagnosed,the mortality is high.Saving should be equaled with the diagnosis and treatment.The application of wound exploration,abdominal puncture,ultrasound examination and X ray checking is valuable to the diagnosis.The patient with operation indication should be operated at once,while the others should be observed for some time to prevent the delayed clinical manifestation.