56例十二指肠瘀滞症临床分析  

Duodenal stasis syndrome: clinical analysis of 56 cases

作　　者：李军[1] 王励之 张杨[1] 王江 陈超武 Li Jun;Wang Lizhi;Zhang Yang;Wang Jiang;Chen Chaowu(Department of Gastroenterology Surgery,The First Affiliated Hospital of Hunan Normal University,Hunan Provincial People’s Hospital,Changsha 431000,Hunan,China)

机构地区：[1]湖南师范大学第一附属医院湖南省人民医院胃肠外科

出　　处：《右江民族医学院学报》2019年第6期625-628,共4页Journal of Youjiang Medical University for Nationalities

基　　金：湖南省自然科学基金项目(2019JJ50321)

摘　　要：目的探讨十二指肠瘀滞症的临床特征、诊断方法、临床治疗手段及治疗效果。方法回顾性分析我科2008年1月-2018年12月收治的56例十二指肠瘀滞症患者的临床特点、影像学特点、治疗方式及疗效。结果56例十二指肠瘀滞症患者病因及治疗结局:37例肠系膜上动脉压迫所致,其中29例综合治疗后无任何不适症状出院,1例术后因营养不良和多器官衰竭死亡,1例术后出现吻合口瘘并肺部感染,术后20 d死亡。12例肿瘤所致十二指肠瘀滞,其中7例无瘤生存至今,1例出现肿瘤复发,4例分别于术后6个月、2年、3年、5年肿瘤复发并广泛转移而死亡。4例炎症引起粘连、扭转所致,1例环状胰腺所致,1例淋巴结肿大所致,1例不明原因所致,这7例经保守或(和)手术治疗出院后,均未再出现恶心呕吐等症状,存活至今。结论十二指肠瘀滞症临床特征不典型,需根据临床经验和影像学来诊断,并综合分析其病因,选择个体化治疗方案。Objective To explore the clinical features,diagnostic methods,clinical treatment methods and efficacy of duodenal stasis syndrome.Methods Retrospective analysis of the clinical features,imaging features,treatment methods and efficacy was conducted for 56 patients with duodenal stasis cared at our department from January 2008 to December 2018.Results Causes and outcomes of 56 duodenal stasis cases:37 cases were caused by superior mesenteric artery compression,and among which 29 cases were discharged from hospital without any discomfort symptoms after comprehensive treatment,and 1 case died of malnutrition and multiple organ failure after operation,and 1 patient who had developed post operative anastomotic fistula and pulmonary infection died 20 days after operation.Out of 12 cases of duodenal stasis caused by tumors,7 cases survived without tumors,1 case had tumor recurrence,and 4 cases died of tumor recurrence and extensive metastasis 6 months,2 years,3 years and 5 years after operation respectively.There were 4 duodenal stasis cases induced by adhesion and torsion that were resulted from inflammation,1 case induced by circular pancreas,1 case induced by lymph node enlargement,and 1 case induced by unexplained cause,and after discharging from hospital nausea and vomiting did not occur again in all these 7 patients who had received conservative or(and)surgical treatment,and they survived till now.Conclusion The clinical features of duodenal stasis are atypical,and it is necessary to diagnose according to clinical experience and imaging,and comprehensively analyze the causes and choose an individualized treatment plan.

关 键 词：十二指肠瘀滞症 临床体征 影像学 外科治疗 

分 类 号：R656.6[医药卫生—外科学]