摘要
目的探讨十二指肠损伤术后导致肠瘘发生的危险因素。方法对1981年10月至2001年10月我院收治的十二指肠损伤34例临床资料进行回顾性分析。结果统计显示患者十二指肠损伤后就诊时间的早晚、有无胰腺损伤和术前有无休克在十二指肠瘘发生与否的两组中差异有显著性意义和非常显著性意义(P<0.05,P<0.05和P<0.001);十二指肠损伤的严重程度与十二指肠瘘是否发生两组之间差异无显著性意义。结论十二指肠损伤应早期诊断和早期处理,根据十二指肠损伤的位置、严重程度以及是否合并其它脏器损伤决定具体手术方式。对血液动力学不稳定患者应根据损伤控制步骤进行简化探查,对Ⅲ级及Ⅲ级以上十二指肠损伤多采用十二指肠修补术及十二指肠憩室化术。
Objective To investigate the risk factors leading to duodenal fistula of patients with duodenal injury. Methods Clinical data of 34 patients with duodenal injury from Oct 1981 to Oct 2001 were collected and analyzed retrospectively.Results A total of 34 patients were admitted with duodenal injuries. The analysis showed that duodenal fistula occurred more common in patients with longer injury operation interval, associated injuries to the pancreas and preoperative shock(P< 0 05)and was not related with severity of duodenal injury(P< 0 05). Conclusions Duodenal injuries should be diagnosed and managed earlier. Treatment of duodenal injuries should be based on severity and location of the injuries and the presence of associated injuries. Duodenorrhaphy and diverculization should be performed on most of the patients with duodenal injuries of grade Ⅲ and above grade Ⅲ. In the hemodynamically unstable patients, the abbreviated laparotomy should be done based on the so called damage control approach.
出处
《中华胃肠外科杂志》
CAS
2002年第2期117-119,共3页
Chinese Journal of Gastrointestinal Surgery
