外伤致闭合性十二指肠损伤16例诊治分析

目的探讨外伤致闭合性十二指肠损伤合理的诊治措施。方法回顾性分析16例外伤致闭合性十二指肠损伤的临床资料。结果全组无漏诊,术前确诊6例,早期诊断率100%,其余10例均于术中确诊;十二指肠损伤主要为降部及横部,共11例(68.7%)。全组死亡2例,共发生各种并发症11例次。结论早期诊断,选择合理手术方式、充分的十二指肠减压和腹腔引流、术后综合治疗可降低并发症,提高治愈率。

Diagnosis and treatment for 16 cases of blunt duodenal injury

Objective To explore the reasonable diagnosis and treatment for blunt duodenal injury.Methods A retrospective study was carried out in 16 patients who sustained blunt duodenal injuries which were affirmed by operation.Results An early diagnosis ratio of 100% was accomplished with 6 patients who were diagnosed before operation.There was no missed diagnosis.The descending and horizontal duodenum was the most common site of blunt injuries with a morbidity of 68.7%(11/16).Two patients died with a mortality of 12.5%.Eleven complications of different kinds occurred.Conclusion Early diagnosis,timely and proper operation,adequate decompression of duodenum and sufficient drainage of peritoneal cavity along with effective combined postoperative therapy are critical to reduce mortality and morbidity.