闭合性十二指肠损伤的诊断与治疗对策

目的探讨闭合性十二指肠损伤的早期诊断方法及治疗效果。方法回顾性分析经手术证实的22例闭合性十二指肠损伤的临床资料。结果术前早期确诊7例(31.8%),受伤部位主要为十二指肠第二段,共10例,占45.5%。全组死亡4例(18.2%),共发生各种并发症11例次。结论详细的病史询问、细致全面的体格检查、有针对性的辅助检查和仔细全面的术中探查可提高早期诊断率;早期诊断、及时正确的手术治疗、充分的十二指肠减压和腹腔引流、全身营养支持治疗是降低并发症和提高生存率的关键。

Diagnosis and Treatment for Blunt Duodenal Injuries

Objective To explore the managements of early diagnosis and suitable treatments for blunt duodenal injuries.Method A retrospective study was made in 22 patients who sustained blunt duodenal injuries which were affirmed by operation.Results Early diagnosis were accomplished in 7 patients with a early-diagnosis ratio of 31.8%.The descending part of duodenum was the most common site of blunt injuries with a morbidity of 45.5%(10/22).Four patients died with a mortality of 18.2%.Eleven complications of different kinds occurred.Conclusions Complete trauma history enquirement,careful physical check-up,highly specific examination and careful and general intra-operative exploration are beneficial in early diagnosis for blunt duodenal injuries.Early diagnosis,timely proper operation,adequate decompression of duodenum and sufficient drainage of peritoneal cavity along with effective nutrition supports are critical to reduce mortality and morbidity.