十二指肠损伤的诊断治疗

目的探讨提高十二指肠损伤的早期诊断率和合适的治疗方法.方法回顾性总结我院1978～2002年间收住的十二指肠损伤19例临床经验.结果 19例中14例(74%)为严重多发伤,全部经手术治疗.行十二指肠修补术10例.修补加十二指肠憩室化3例,十二指肠空肠Roux-en-y吻合3例.胰十二指肠切除术1例,改良憩室化再简化手术2例.治愈17例,死亡2例.死亡原因为多脏器损伤,感梁性休克、多器官功能衰竭.结论正确处理和恰当的术式是救治严重多发伤十二指肠破裂的关键.

Diagnosis and Treatment of Duodenal Injury

Objective To improve the accuracy of early diagnosis and choose suitable management for duodenal injury. Methods Clinical experience was summerized during recent 25 years. Results Of the 19 patierts, 14(74%) had multiple injuries. All patients were treated by operations, including 10 with primary repair , 3 with repair plus duodenumcele, and 3 with Roux-en-y duodeno-jejunostomy, 1 with pancreatoduodenectomy, 2 with modified Cogbill's method. Seventeen patients were cured successfully,and 2 died of multiple organs injuries, septic shock and multiple organ failure. Conclusions Correct treatment and appropriate operation are essential for duodenal rupture in severe multiple injuries.