闭合性十二指肠损伤的早期诊断

目的 探讨闭合性十二指肠损伤的早期诊断原则：方法 回顾分析了本院自1962年至今29例闭合性十二指肠损伤的诊断过程，包括腹部X线、腹腔穿刺、腹腔灌洗、超声和CT检查。受伤后24小时以内获诊治25例，24小时后获诊治4例。结果 术前正确诊断5例，其余均为对闭合性十二指肠合并伤行剖腹探查时获诊。24小时内诊断并手术25例，死亡2例，死亡率8％，而24小时后再行诊治4例中3例死亡，死亡率75％。结论 早期诊断对闭合性十二指肠损伤有重要意义：高度警惕是早期诊断的前提，仔细探查是早期诊断的关键。联合运用多种辅助诊断方法，必要时重复使用，有助于早期正确诊断。

Early diagnosis of blunt duodenal trauma.

Objective To discuss the basic principle of early diagnosis of blunt duodenal trauma. Methods A retrospective analysis in 29 cases with blunt duodenal trauma had been made since the year of 1962. The diagnostic proceeding included the use of abdominal radiography, peritoneal lavage, ultrasonagraphy and computed tomography. Results only 5 cases were correctly diagnosed before operation The diagnoses of the rest cases were confirmed via laparotomy. 25 cases had been diagnosed operated on within 24 hours with mortality of 8 percent(2 case). The diagnoses oi 4 cases were delayed 24 hours later with the mortality 75 percent(3 cases). Conclusion delayed diagnosis and treatment of blunt duodenal trauma will increase the mortality and morbidity apparently. Keeping alarm, careful explorative check-up during laparotomy and associated and repeat using of some diagnostic means are key factors in early diagnosis of blunt duodenal trauma.