Hassan三管法和双管法在十二指肠损伤修补术中的临床应用  

Application of Hassan triple-tube versus double-tube method for repairing duodenal rupture

作　　者：刘恒山 朱高波[1] 宋京翔[2] 许俊[3] Liu Hengshan;Zhu Gaobo;Song Jingxiang;Xu Jun(Department of Emergency&Trauma,Central Municipal People′s Hospital,First College of Clinical Medical Science,China Three Gorges University,Hubei Yichang 443003,China;Department of General Surgery,No.900 Hospital of PLA Joint Logistic Support Force,Fujian Fuzhou 350025,China;Department of Gastrointestinal Surgery,Central Municipal People′s Hospital,First College of Clinical Medical Science,China Three Gorges University,Hubei Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院(宜昌市中心人民医院)急诊与创伤外科,湖北宜昌443003 [2]中国人民解放军联勤保障部队第900医院普通外科,福建福州350025 [3]三峡大学第一临床医学院(宜昌市中心人民医院)胃肠外科,湖北宜昌443003

出　　处：《腹部外科》2023年第3期217-221,共5页Journal of Abdominal Surgery

基　　金：湖北省自然科学基金(2020CFB566)。

摘　　要：目的 探讨Hassan三管法与双管法在十二指肠损伤修补术中的临床应用。方法 回顾性分析2011年7月至2021年7月宜昌市中心人民医院和中国人民解放军联勤保障部第900医院收治的52例十二指肠损伤破裂修补术病人的临床资料。术中十二指肠内减压方法分别采用双管法(双管组,23例)和三管减压法(三管组,29例),比较两组病人住院期间术后并发症的发生情况、住院时间以及减压管拔出时间。结果 双管组与三管组病人术后住院期间并发症包括十二指肠瘘(3例比5例)、腹腔感染(4例比8例)、肠梗阻(2例比5例)、胆瘘(9例比11例)、胰瘘(11例比13例),差异均无统计学意义(均P>0.05)。双管组与三管组比较,住院时间少[(26.8±10.6) d比(34.1±11.6) d,P<0.05],减压管的拔除时间早[(19.6±9.5) d比(25.7±10.4) d,P<0.05]。结论 十二指肠修补术中行双管法与三管法均有良好的临床疗效。双管组较三管组拔管时间早、恢复快,合理有效的双管置入可能较三管法更有优势。Objective To explore the application of Hassan triple-tube versus double-tube method for repairing duodenal rupture.Methods For this retrospective cohort study,clinical data were retrospectively reviewed for 52 patients undergoing duodenal rupture repairing with Hassan tube at both hospitals from July 2011 to July 2021.They were divided into two groups of triple-tube(n=29)and double-tube(n=23).Baseline profiles,injury characteristics,postoperative complications,decompression tube removal time and duration of hospital stay were recorded.Results During postoperative hospitalization,no significant inter-group differences existed in occurrences of duodenal fistula(3 vs.5 cases),abdominal infection(4 vs.8 cases),intestinal obstruction(2 vs.5 cases),biliary fistula(9 vs.11 cases)or pancreatic fistula(11 vs.13 cases)(P>0.05).Average length of hospital stay was shorter in double-tube group than that in triple-tube group[(26.8±10.6)vs.(34.1±11.6)days](P<0.05).Duodenal decompression tube was removed earlier in double-tube group than in triple-tube group[(19.6±9.5)vs.(25.7±10.4)days](P<0.05).Conclusion Both techniques are efficacious for repairing duodenal rupture.Decompression tube extubation time and hospital stay are shorter in double-tube group than those in triple-tube group.During duodenal repair,reasonable and effective double-tube insertion may be more advantageous than triple-tube.

关 键 词：十二指肠损伤 减压 外科手术 

分 类 号：R641[医药卫生—外科学]