经十二指肠置管减压术联合经空肠造瘘插管十二指肠减压术治疗十二指肠创伤

目的观察经十二指肠置管减压术联合经空肠造瘘插管十二指肠减压术治疗十二指肠创伤的临床效果。方法60例十二指肠创伤患者随机分为两组，30例患者采用单纯十二指肠置管减压术作为对照组，30例患者采用经十二指肠置管减压术联合经空肠造瘘插管十二指肠减压术作为观察组，观察两组患者手术一般情况及术后并发症发生情况，同时在手术当天及术后7d评价患者营养状态。结果两组手术时间及术中出血量差异均无统计学意义（均P〉0．05），观察组术后无1例发生十二指肠瘘，对照组4例（13．33％）发生十二指肠瘘，两组差异有统计学意义（x^2=4．286，P〈0．05）；两组术后并发腹腔脓肿、肺部感染、切口感染等差异均无统计学意义（均P〉0．05）。观察组术后7d体质量及右上臂周径稳定率均明显高于对照组（x^2=7．519、9．868，均P〈0．05）。结论经十二指肠置管减压术联合经空肠造瘘插管十二指肠减压术治疗十二指肠创伤手术减压效果显著，可明显降低十二指肠瘘的发生，改善患者营养状况，促进十二指肠创口的愈合。

The clinical observation of duodenal catheter decompression and intubation by the jejunum ostomy duodenal decompression in the treatment of duodenal trauma

Objective To observe the clinical effect of treatment of duodenal trauma intubation duodenal de- compression jejunostomy jointly by the duodenal eatheter decompression. Methods 60 patients with duodenal trau- ma were randomly divided into two groups,30 eases were treated with simple duodenal eatheter decompression as con- trol group,30 eases treated with duodenal catheter decompression joint jejunum ostomy intubation duodenal decom- pression as the observation group, generally observed two groups of patients surgery and postoperative complications, in the day of surgery and postoperative 7d evaluation of patients with nutritional status. Results The surgical time and blood loss of the two groups had no statistically significant difference （ P 〉 0.05 ）, the observation group had no ease of duodenal fistula and four eases in the control group （ 13.33% ） oeeumed duodenal fistula. The difference between the two groups was statistically significant （X^2= 4. 286, P 〈 0.05 ）. Postoperative concurrent abdominal abscess, lung infection,wound infeetion had no statistically significant differences （P 〉 0.05 ）. After observation group 7d body mass and right upper ann muscle circumference stability was significantly higher than that in the control group （ X2 = 7. 519,9. 868, both P 〈 0.05）. Conclusion Jejunostomy joint duodenal catheter decompression intubation duodenal decompression in treatment of duodenal trauma surgieal decompression had significant effeet, can significantly reduce the incidence of fistula,improve patients nutritional status,promote the duodenal wound healing.