创伤性十二指肠外瘘

本文报告17例创伤性十二指肠外瘘,损伤破裂部位均发生于降段和水平段。患者合并多发复合伤,创伤后首次手术至肠瘘发生的间隔期平均为5.3天。在我院的平均住院天数为73.2天,其中15例接受平均37.6天的营养支持治疗,10例接受手术治疗,有3例接受十二指肠外瘘治疗性手术。本组2例死亡,15例痊愈,其中12例非手术治愈,肠瘘自然愈合率为80%。还讨论了创伤性十二指肠外瘘发生的原因、诊断和治疗要点,强调充分的营养支持和有效的腹腔引流是治愈和提高肠瘘自愈率的关键。

Traumatic duodenal fistula

Seventeen patients with duodenal trauma complicated with fistula were presented.All injured areas were multiple and located in the descending and horizontal parts of the duodenum.The mean interval from the initial operation to the occurrance of duodenal fistula were 5.3 days.Fifteen patients received nutritional therapy.Operative procedures were performed in 10 patients but definitive operations were accomplished in only 3 patients.2 patients were unsurvival,12 of 15 patients reco- vered without definitive oparation.The hospitalization days ranged from 3 to 227 days (mean 73.2 days).The etiology,diagnosis and treatment of the traumatic duodenal fistula were discussed in detail with the emph- asis on the keypoints of appropriate nutritional therapy and effective intraabdominal drainage for improving the spontaneous closure rate and the quality of final result.