医源性十二指肠损伤14例原因分析及处理  

Iatrogenic duodenal injuries and treatment： a report of 14 cases

作　　者：于仁[1] 葛恒发[1] 姜宝飞[1] 陶国全[1] 钱燕[1] 

机构地区：[1]南京医科大学附属淮安第一医院胃肠外科,223300

出　　处：《中华全科医师杂志》2011年第12期901-902,共2页Chinese Journal of General Practitioners

摘　　要：回顾分析2000年1月至2010年1月我院及外院转入共14例医源性十二指肠损伤患者的临床资料。14例中，术中发现9例，即刻行修补或附加空肠造口内、外引流术，均痊愈；术后〈24h发现2例，1例痊愈，1例术后低流量十二指肠瘘经保守治疗痊愈；术后24～72h发现2例，再次手术后均死亡；1例术后7d才发现者来院时已感染性休克，抢救无效，4h后死亡。提示，十二指肠损伤术中发现者，经妥善处理预后佳；术后早期（〈24h）发现且能正确处理，预后较好；超过48h者预后差。Clinical data of 14 patients with iatrogenic duodenal injuries treated in hospital from JanuatT 2000 and January 2010 were retrospectively reviewed. Iatrogenic duodenal injuries were found intraoperatively in 9 cases, in whom repair or additional jejunostomy was performed and all were cured and discharged. In 2 patients the duodenal injuries were found within 24 hours postoperatively, l was cured, another had low flow duodenal fistula and cured with conservative treatment. Duodenal bypass and extraoral drainage were performed in 2 patients whose duodenal injuries was found 72 hours after surgery and died from severe infection of retroperitoneal space and multiple organ failure respectively. One patient whose duodenal injmT was found 7 d postoperatively suffered from septic shock and died in 4 h after admission. The results suggest that early detection and early management would result in satisfied outcome for patients with iatrogenic duodenal injuries, the first 24 hours are crucial.

关 键 词：十二指肠疾病 治疗结果 

分 类 号：R656.64[医药卫生—外科学]