十二指肠损伤术后并发症相关因素分析  

Relative factors analysis of postoperative complications related to duodenal injury

作　　者：陈忠[1] 王耀东[1] 田毅峰[1] 赖智德[1] 林天生[1] CHEN Zhong;WANG Yaodong;TIAN Yifeng(Department of Hepatobiliary Surgery,Fujian Provincial Hospital,Clinical Medical College of Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院肝胆外科/福建医科大学省立临床医学院,福州350001

出　　处：《临床外科杂志》2018年第11期855-857,共3页Journal of Clinical Surgery

摘　　要：目的研究十二指肠损伤术后并发症发生的相关因素。方法手术治疗的十二指肠损伤病人72例,根据是否在发病24小时内手术干预分为早期治疗组(39例)和对照组(33例),根据是否按照损伤控制外科理念(DCS)规划手术分为DCS组(35例)和非DCS组(37例)。分别比较两组病人间术后腹腔感染、腹腔出血、多器官功能障碍综合征(MODS)的发生率以及病死率。结果早期治疗组术后并发症发生率为41. 02%,病死率为5. 12%,对照组分别为75. 75%和24. 24%,早期治疗组术后并发症发生率和病死率均低于对照组,两组比较差异有统计学意义(P <0. 05)。DCS组术后并发症发生率为37. 14%,病死率为2. 85%,非DCS组分别为75. 67%和24. 32%,DCS组术后并发症发生率和病死率均低于非DCS组,两组比较差异有统计学意义(P <0. 05)。结论早期诊断尽早手术干预,采用损伤控制外科理念诊治能够降低十二指肠损伤术后并发症发生率及病死率。Objective To study on the related factors of postoperative complications of duodenal injury.Methods A retrospective review of 72 cases of duodenal injury treated,the patients were divided into early treatment group(39 cases) and control group(33 cases) according to whether the intervention occurred within 24 hours after onset of disease.The patients were divided into the DCS group(35 cases) and the non DCS group(37 cases) according to whether the operation was planned according to the concept of damage control surgery.The incidence and mortality of postoperative complications like celiac infection,intraperitoneal hemorrhage,multiple organ dysfunction syndrome(MODS) were compared between the two groups.Rusults The incidence of postoperative complications in the early treatment group was 41.02% and the mortality was 5.12%.In the control group,the incidence of postoperative complications was 75.75% and the mortality was 24.24%.The incidence and mortality of postoperative complications in the early treatment group were lower than those in the control group.The difference between the two groups was statistically significant(P<0.05).The incidence of postoperative complications in DCS group was 37.14%,the mortality rate was 2.85%.The incidence of postoperative complications in non DCS group was 75.67%,and the mortality rate of 24.32%.The data of DCS group was lower than that of non DCS group(P<0.05).Conclusion Early diagnosis and early surgical intervention and treatment with the concept of injury control surgery can reduce the incidence of postoperative complications and mortality of duodenal injury.

关 键 词：十二指肠损伤 早期诊断 外科治疗 

分 类 号：R656.64[医药卫生—外科学]