目的 探讨创伤性十二指肠三、四段破裂的外科治疗。 方法 回顾性总结分析我院1992～2002年收治的12例创伤性十二指肠三、四段破裂患者的临床资料。 结果 单纯性损伤3例，合并伤9例。行十二指肠单纯修补1例； 行修补或吻合加下移鼻胃管至十二指肠及空肠造口逆行置管引流减压、空肠造瘘(简称三管减压)8例； 行十二指肠空肠Roux-en-Y吻合2例，11例均治愈； 1例合并糖尿病者，因术后并发肠瘘、电解质紊乱及酮症酸中毒死亡。 结论 小肠系膜根部及横结肠系膜根部血肿的探查是发现十二指肠三、四段破裂的关键。十二指肠修补或吻合加三管减压和十二指肠空肠Roux-en-Y 吻合是治疗十二指肠三、四段破裂有效的手术方法。根据伤情选择合理、安全的术式是提高疗效的关键。
【Abstract】ObjectiveTo generally analyze the current situations of clinical research and applications in early enteral nutrition (EEN) after abdominal surgery. MethodsThe published papers about the current situations of clinical research and applications in EEN after abdominal surgery were reviewed. ResultsEEN after abdominal surgery seems to be safe and effective, produces a positive nitrogen balance, keeps the integrality of structure and function of the apparatus, protects gut barrier, and reduces or prevents septic complications. ConclusionEEN may be of more benefits and will be one of the best methods of nutrition support after abdominal surgery.