十二指肠损伤的诊断和治疗
十二指肠,,],十二指肠；损伤；诊断；手术治疗,1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 探讨十二指肠损伤的特点及手术方法，以提高十二指肠损伤的诊治水平。方法 回顾性分析36例十二指肠损伤的临床资料。结果 单纯性十二指肠损伤仅5例，有合并伤者31例。全部病例均经手术治疗，治愈31例(86.1%)，术后并发症10例(27.8%)，死亡5例(13.9%)。结论十二指肠损伤早期诊断困难，应保持警觉，综合判断。按损伤类型及十二指肠损伤情况，选择适当的术式，以提高生存率，减少并发症的发生。[关键词] 十二指肠；损伤；诊断；手术治疗
Diagnosis and treatment of duodenal trauma
LAI Xiangqun, QIU Qingning
(Department of Emergency Medicine, The People’s Hospital of Xingning City, Xingning 514500, China)
Abstract: ObjectiveTo study the clinical features of duodenal trauma and the surgical methods in improving therapeutic effects. Methods The clinical data of 36 patients with duodenal trauma were retrospectively analyzed. According to Lucas classification, the injury of grade Ⅰ in 8 cases, grade Ⅱ in 20, grade Ⅲ in 5 and grade Ⅳ in 3. Five cases were single duodenal trauma, others were respectively combined with the injuries of biliary tract, liver, spleen, pancreas, intestine, kidney, colon, chest or head, as well as shock. Results Thirteen cases underwent single neoplasty of duodenum, 16 RouxenY anastomosis, 5 improved Cogbill diverticulum and 2 duodenopancreatectomy. Postoperative complications took place in 10 cases, 5 died. Thirtyone were cured. Conclusion Early diagnosis of duodenal trauma is difficult, so alertness and comprehensive judgement are the key factors in the diagnosis of duodenal injury. The proper choice of surgical approaches based on the injury types and the condition of duodenal trauma may be beneficial for improvement of survival rates and decrease of complication occurrence. ......
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