原发性十二指肠损伤的诊断与治疗

The diagnosis and treatment of primary duodenum injury:A report of 17 cases

目的 :对十二指肠损伤的临床特点 ,诊断及外科治疗结果进行分析。方法 :回顾性总结 ,1984～ 1999年经手术证实的十二指肠损伤患者 17例。结果 :单纯十二指肠损伤 3例 ,合并伤 14例 ,其中合并 2个以上脏器损伤 8例。损伤部位以降部及降部与水平部交界处为多 ,有 13例 ,16例治愈 ,有术后并发症者 4例 ,死亡 1例 ,结论 :掌握十二指肠损伤的临床特点 ,提高术中探查的确诊率 ,根据伤情选择合理、安全的术式 ,建立有效的十二指肠引流减压 ,及时治疗术后并发症是提高疗效的关键。

Objective: To analyze the clinical characteristics of the diagnosis and management of primary duodenal injury. Methods: We reviewed 17 cases of duodenal injury proved by laparotomy between 1984 and 1999. Results: There were 3 cases of simple duodenal injury.and 14 cases of complicated injury,and 8 of 17cases 8 cases suffered from injuries of 2 or more organs. Injuries of the discending part and the border between discending part and level part were found in 13 of the 17 patients. sixteen cases were cured and postoperative complication ocurred in 4 cases, and one died . Conclusion: We should grasp the clinical characteristics of duodenal injury and improve the rate of definite diagnosis in the course of laparotomy to use safe and effective procedures according to injury and build up effective drainage and decompression of the duodenum. The operative effectiveness lies in prompt and correct treatment of postoperative complications.