刘志民 冯延昌 杨维俭 崔庆 杨维良

    (刘志民，冯延昌，杨维俭，崔庆)255036 张店，山东省淄博市中心医院普通外科；(杨维良)150086 哈尔滨，哈尔滨医科大学附属第二医院外科 中国胃肠外科杂志 1999 0 2 3


    关键词：十二指肠损伤；诊断；治疗；手术 期刊 zgwcwkzz 0 论著 fur -->


    

【摘要 】 目的 提高十二指肠损伤的早期诊断率和选择合适的治疗方法。方法 总结1983年1月至1998年12月收治的17例十二指肠损伤患者的临床资料。多为严重多发伤，致伤原因以车祸伤为主，全部经手术治疗。行十二指肠修补术11例，十二指肠改良憩室化手术4例，改良憩室化再简化术和十二指肠Roux-en-Y吻合术各1例。结果 治愈14例，死亡3例。致死原因为十二指肠瘘和多器官功能障碍综合征。十二指肠瘘和腹腔脓肿是主要的并发症。结论 十二指肠损伤早期诊断和及时手术处理是非常重要的。改良十二指肠憩室化和十二指肠修补术是比较实用的手术方法。

Experience and lesson inthe diagnosis and treatment of duodenal injury

LIU Zhimin, FENG Yanchang, YANGWeijian, et al. Zibo Municipal Central Hospital, Zhangdian 255036

【Abstract 】 Objective To increase the accuracy of earlydiagnosis and decrease postoperative complications, and to choose a suitable management ofduodenal injury. Methods 17 patients with duodenal injury were treated from January, 1983 toDecember, 1998 in Zibo Municipal Central Hospital. The most of them were multipleinjuries. The main cause of injury was traffic accident. All patients were treated byoperation, 11 patients with primary repair, 4 cases with Cogbill's techniques for diverticularization, one with modified Cogbill's method and one Roux-en-Y duodenojejunostomy, respectively. Results 14 patients were cured successfully, 2 died from theduodenal fistula and 1 multiple organ dysfunction syndrome. The main complications werefistula and intra-abdominal abscess. Conclusion It is very important that the early diagnosis andtreatment in time for duodenal injury. The primary repair and Cogbill's techniques fordiverticularizations are practical.

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