外伤性十二指肠损伤13例临床分析

目的：探讨外伤性十二指肠损伤的诊断和外科治疗方法。方法：回顾性分析13例十二指肠损伤患者的临资料及诊断治疗情况。结果：13例患者均为闭合性损伤，仅3例术前明确诊断，术中确诊9例，术中漏诊、术后诊断1例，误诊率7．7%，死亡1例，治愈12例，治愈率92．3％。十二指肠损伤的早期诊断和早期及时手术是非常重要的。结论：十二指肠损伤的病情复杂，在上腹部损伤要仔细探查十二指肠，对提高十二指肠损伤的诊断有一定价值。十二指肠损伤可行单纯修补术，十二指肠端端吻合术及十二指肠空肠Roux-en-Y吻合术、胃空肠双管造瘘十二指肠减压是治疗十二指肠损伤的较好方法。

Clinical Analysis on 13 Cases of Traumatic Duodenal Injury

Objective.. To probe into the diagnosis and surgical treatment for traumatic duodenal injury. Methods： Clinical data and diagnosis and treatment state of 13 patients with duodenal injury were analyzed retrospectively. Results： 13 patients were all closed injury, only 3 got sure preoperative diagnoses, 9 got sure intraoperative diagnoses, 1 intraoperative missed diagnosis, 1 got postoperative diagnosis, the mistake diagnose rate was 7.7%, 1 died, 21 were cured, the recovery rate was 92. 3%. Early diagnosis and treatment for duodenal injury were very important. Conclusion： The pathogenetic condition of duodenal injury is complex, stalk the duodenum carefully when we meet the upper abdomen injury, it have certain value to the diagnosis of improving the duodenal injury. Simple kposthesis and duodenum end to end anastomosis and Roux-en-Y duodenojejunostomy and Modificed Cogbill＇s techniques for diverficalization are practical operation for duodenal injury.