【摘要】 目的探讨如何避免十二指肠损伤的漏诊。方法回顾性分析我院450例腹部外伤中漏诊的8例十二指肠损伤病人处理和临床特点。结果致伤原因以车祸伤为主(6例),复合伤6例,术前无一例正确诊断为十二指肠伤,所有病例均行手术治疗,6例治愈,死亡2例,死亡原因为严重感染及多器官功能衰竭。漏诊的主要原因为认识不足并缺乏相应的特殊检查。结论对有严重上腹外伤史者,应高度警惕十二指肠损伤,反复的物理检查,动态的辅助检查尤其是CT检查,及时剖腹探查等可减少十二指肠损伤的漏、误诊率。更多还原

【Abstract】 Objective To explore how to avoid the missed diagnosis of duodenal injuries.Methods 8 cases with duodenal injuries of the missed diagnosis in 450 cases of abdominal injuries were analyzed retrospectively in the management and clinical feature.Results The major cause of injury was traffic accident, and 6 cases were multiple injuries. No case of 8 duodenal trauma patients was diagnosed accurately before operation. All patients were treated with operative therapy, and 6 patients were cured successfully, and other 2 cases died from serious infection and MODS. Main cause of the missed diagnosis is deficiency of knowledge to duodenal injuries and absence of special adjunctive examination to this kind of injury.Conclusion These measures include keeping duodenal injuries in mind when upper abdomen trauma occur and repeat physical examination of abdomen and dynamic adjunctive examination, and especially CT scan, and also operative exploration in time can reduce the rate of the missed diagnosis of duodenal trauma.更多还原