闭合性十二指肠损伤57例的诊治体会

王晖，龚伟

（陕西省人民医院急诊外科，陕西 西安，710068）

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摘要：

目的 总结初期诊治闭合性十二指肠损伤的经验。方法 选取2014年1月至2016年12月我院收治的闭合性十二指肠损伤患者57例，回顾性分析其临床资料，归纳十二指肠损伤的诊断及治疗要领。结果 在57例患者中，首次就诊的54例患者中51例经早期诊断确诊（94.44%）；55例十二指肠损伤治愈，治愈率为96.49%（55/57）；2例病死，病死率为3.51%（2/57）。结论 根据病史和辅助检查史，仔细进行早期诊断并及时有效地治疗，对患者的预后有着非常重要的意义。术中探查是早期诊断和治疗的关键，也是提高患者临床疗效的重中之重，对胰十二指肠损伤病情较为危重的多发伤患者应积极、初期应注重损伤控制以改善预后，提高治愈率。

关键词：十二指肠损伤；外科治疗；诊断；损伤控制性外科治疗

中图分类号：R656文献标志码：A文章编号：2096-1413(2017)12-0150-02

Experience of diagnosis and treatment of 57 cases with closed duodenal injury
WANG Hui, GONG Wei
(Department of Emergency, Shaanxi Provincial People`s Hospital, Xi`an 710068, China)

ABSTRACT: Objective To summarize the experience of diagnosis a nd treatment of patients with closed duodenal injury. Methods Fifty-seven cases of closed duodenal injury patients in our hospital from January 2014 to December 2016 were selected and analyzed. The diagnosis and treatment skills of duodenal injury were summarized. Results In 57 cases of closed duodenal injury patients, there were 51 cases received early diagnosis (94.44%) in 54 cases of first visit. 55 cases of duodenal injury were cured, the cure rate was 96.49% (55/57); 2 cases died, the mortality was 3.51% (2/57). Conclusion According to the injury history and the history of auxiliary examination, carefully early and timely diagnosis and effective treatment are very important in the prognosis of patients. Intraoperative exploration is not only the key to early diagnosis and treatment, but also the most important thing to improve the patients` clinical effect. For patients with severe injury of pancreatic and duodenal injury, the patients with multiple injuries should be active and use the principle of injury control in order to improve the recovery rate.
KEYWORDS: duodenal injury; surgical treatment; diagnosis; damage control surgery treatment

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