十二指肠损伤的诊断与治疗

目的 提高十二指肠损伤的诊断率及外科治疗水平。方法 回顾性总结1988—2001年收治的16例十二指肠损伤病人。结果 合并腹部其它脏器损伤13例，单纯十二指肠损伤3例。损伤部位以十二指肠降部及降部与水平部交界处为多见，有12例，占75％。治愈14例，死亡2例，致死原因为多器官功能障碍综合征。有术后并发症者4例，十二指肠瘘和腹腔脓肿是主要的并发症。结论 掌握十二指肠损伤的临床特点，早期诊断，及时的手术处理及恰当的术后管理是提高治愈率的关键。

Diagnosis and treatment of the injury of the duodenm

Objective To improve the rate of diagnosis and the result of surgical treatment in patients suffering from duodenal injuries.Methods The clinical data of 16 cases of duodenal injury at our hospital between 1988 and 2001 were summarized retrospectively.Results There were 3 cases of simple duodenal injury,13 cases complicated by other intraabdominal organ injuries.Injuries of discending part and border between discending part and level part were found in 12 of 16 patient(75%).Fourteen cases(87.5%) were cured and 2 cases died(12.5%) due to multiple organ dysfunction syndrome(MODS).Four cases developed postoperative complications and duodenal fistula and abdomenal abscess were main postoperative comlpication.Conclusion Better understanding of the clinical features of duodenal trauma,early diagnosis,operation in time,proper postoperative management are the keys to better prognosis in patients with duodenal trauna.