十二指肠

Additional pathologic findings included: chronic peptic duodenitis (6 out of 17, 35%), active duodenitis (1 out of 17, 6%), and celiac-like features (2 out of 17, 12%) in the duodenum; chemical gastropathy (3 out of 18, 17%), active chronic gastritis without Helicobacter pylori (2 out of 18, 11%), and erosion (1/18,6%) in the stomach; reactive epithelial change (3 out of 7, 43%), active esophagitis (3 out of 7, 43%), ulceration (2 out of 7, 29%), and erosion (1 out of 7, 14%) in the esophagus. Serum MPA levels were available in 7 patients, 6 of whom had abnormal duodenal apoptotic counts.

其他病理特点包括：十二指肠：慢性消化性十二指肠炎（17例中有6例，35%）、活动性十二指肠炎（17例中有1例，6%）和乳糜泻样特征（17例中有2例，12%）；胃：化学性胃病（18例中有3例，17%）、慢性活动性胃炎且无HP感染（18例中有2例，11%）和糜烂（18例中有1例，6%）；食管活检：反应性上皮改变（7例中有3例，43%）、活动性食管炎（7例中有3例，43%）、溃疡（7例中有2例，29%）和糜烂（7例中有1例，14%）。7例患者提供了其血清MPA浓度，其中有6例的十二指肠细胞凋亡计数异常。

Result:There were 166 cases that were abnormal in 175 cases ,the incidence of peptic ulcer was 15.43％, the incidence of duodenal ulcer was higher than gastric ulcer in children.the incidence of chronic gastritis and chronic duodenitis was 94.86%, the incidence of chronic gastritis was significantly higher than chronic duodenitis, chronic superficial gastritis, bile reflux gastritis see most, chronic erosion hemorrhage of chronic gastritis and chronic duodenitis was not uncommon.

结果：175例胃镜检查有异常者为166例，消化性溃疡发生率为15.43%，小儿十二指肠溃疡发生率高于胃溃疡，并以十二指肠球部溃疡多见，胃溃疡以胃窦溃疡多见，胃、十二指肠炎的发生率为94.86%，小儿慢性胃炎发生率明显高于慢性十二指肠炎，其中以慢性浅表性胃炎、胆汁返流性胃炎最多见，慢性糜烂出血性胃、十二指肠炎也不少见，幽门螺杆菌检测阳性率为59.04%，其中消化性溃疡病例检测幽门螺杆菌均为阳性。

Result:There were 166 cases that were abnormal in 175 cases ,the incidence of peptic ulcer was 15.43％, the incidence of duodenal ulcer was higher than gastric ulcer in children.the incidence of chronic gastritis and chronic duodenitis was 94.86%, the incidence of chronic gastritis was significantly higher than chronic duodenitis, chronic superficial gastritis, bile reflux gastritis see most, chronic erosion hemorrhage of chronic gastritis and chronic duodenitis was not uncommon. Helicobacter pylori testing positive rate of 59.04%, peptic ulcer cases were all positive detection of helicobacter pylori.

结果：175例胃镜检查有异常者为166例，消化性溃疡发生率为15.43%，小儿十二指肠溃疡发生率高于胃溃疡，并以十二指肠球部溃疡多见，胃溃疡以胃窦溃疡多见，胃、十二指肠炎的发生率为94.86%，小儿慢性胃炎发生率明显高于慢性十二指肠炎，其中以慢性浅表性胃炎、胆汁返流性胃炎最多见，慢性糜烂出血性胃、十二指肠炎也不少见，幽门螺杆菌检测阳性率为59.04%，其中消化性溃疡病例检测幽门螺杆菌均为阳性。

Their ages at operation were between 5 hours and 8.5 years, with a median of 4 days. Surgical treatment included duodenojejunostomy in nine, duodenoduodenostomy in five and duodenotomy with duodenoplasty in one.

病人手术时的年龄介於5小时大与8岁半之间，9个人接受十二指肠空肠造口吻合术，5个人接受十二指肠与十二指肠吻合术，1个人接受十二指肠切开术和十二指肠造形术。

objectiveto investigate the diagnosis and treatment of traumatic duodenal rupture.methodthe clinical data of 13 patients with traumatic duodenal rupture hospitalized from may 1991 to december 2008 were retrospectively analyzed,and the material cause was automobile accident mainly.resultsin these 13 patients,after hospitalization,6 cases were diagnosed in 3 hours,4 cases were diagnosed in 24～72 hours,and 3 cases were diagnosed after 72 hours.three cases with duodenal cleft repair,2 cases with duodenal ostomy,2 cases with duodenum and jejunum roux-en-y anastomosis,1 case with duodenal diverticular surgery,1 case with meliorative duodenal diverticular surgery,1 case with duodenal broken ends closure and anastomosis of stomach with jejunum,1 case with duodenal distal closure and anastomosis of duodenal local with jejunum,and 2 cases with resections of pancreas duodenum.after the operation,6 cases (46.2%) appeared some complications of wound infection,duodenal fistula,digestive tract hemorrhage,pancreatic fistula,abdomen infection and so on.two cases (15.4%) died from multiple system organ failure and septic shock.conclusionthe early diagnosis and correct operation style selection are the keys for duodenal rupture.

目的：探讨外伤性十二指肠破裂的诊断和治疗方法。方法：回顾分析外伤性十二指肠破裂患者13例临床资料。结果：入院后3 h内确诊6例，24～72 h内确诊4例，72 h后确诊3例。3例行十二指肠裂口修补，2例行十二指肠造瘘，2例行十二指肠空肠roux-en-y吻合，1例行十二指肠憩室化手术，1例行改良十二指肠憩室化手术，1例行十二指肠两断端关闭、胃空肠吻合，1例行十二指肠远端关闭、近端与空肠端侧吻合，2例行胰十二指肠切除术。术后6例(46.2%)出现切口感染、十二指肠瘘、消化道出血、胰瘘或腹腔感染等并发症，2例(15.4%)患者死亡，分别死于多器官系统衰竭和感染中毒性休克。结论：早期诊断与正确的术式选择是成功救治外伤性十二指肠破裂的关键。

The experiment two: enzyme preparation significantly improved average daily gainand feed conversion ratio (P＜0.05). Enzyme preparation significantly increased energymetabolizability and digestibility of crude fiber, crude protein and neutral detergent fiber,but had no remarkable effect on digestibility of dry matter, crude fat and acid detergentfiber. Enzyme preparation significantly decreased the relative viscosity of duodenal andjejunal digesta. The pH of intestine had no noticed difference in all groups. Enzymepreparation significantly decreased relative weight of gizzard, proventficulus, duodenum,jejunum and ileum. Enzyme preparation significantly increased villus size of duodenumand jejunum, and villus to crypt ratio of duodenum and ileum significantly increased too.Enzyme preparation considerably decreased ileal crypt height (P＜0.05), and didn"t affectthickness of intestinal wall. Supplementing enzyme preparation, the serum glucose, totalprotein and alanine aminotransferase, but enzyme preparation hadn"t noticed influenceupon uric acid, total cholesterol, triglyceride and high-density lipoproteins. Enzymepreparation significantly increased insulin, triiodothyronine and insulin-like growthfactor-Ⅰ. Adding enzyme preparation, the percentage of thyroid stimulating hormone andgrowth hormone in the serum increased 16.44%, 19.18% and 18.84%, 21.74%respectively, and the percentage of glucagon and thyroxine decreased 12.07%, 14.36% and 13.79%, 15.40%, but failed to reach statistical significance (P＞0.05). Enzymepreparation significantly increased (P＜0.05) the trypsin and amylase activity of duodenaland jejunal digesta, but enzyme preparation didnt affect significantly (P＞0.05) theintestinal lipase activity and pancreatic digestive enzyme. Enzyme preparation had nosignificant effect on caecal microbial population.

试验二：酶制剂显著提高平均日增重和饲料转化率(P＜0.05)；酶制剂显著提高能量代谢率及粗纤维、粗蛋白、中性洗涤纤维消化率(P＜0.05)，而对干物质、粗脂肪、酸性洗涤纤维消化率影响不显著；酶制剂显著降低十二指肠和空肠食糜相对粘度(P＜0.05)；添加酶制剂对肠道pH影响不显著；酶制剂显著降低肌胃、腺胃、十二指肠、空肠、回肠相对重(P＜0.05)，显著提高十二指肠和空肠绒毛高度，显著增加十二指肠和回肠绒毛高度／隐窝深度，降低回肠隐窝深度(P＜0.05)，对肠壁厚度影响不显著；酶制剂显著提高血清葡萄糖、总蛋白和谷丙转氨酶浓度(P＜0.05)，对尿酸、总胆固醇、甘油三酯及高密度脂蛋白浓度影响不显著，显著提高胰岛素、T_3、IGF-Ⅰ水平，添加酶制剂后，促甲状腺激素、生长激素分别提高16.44％、19.18％和18.84％、21.74％，胰高血糖素和T_4分别降低12.07％、14.36％和13.79％、15.40％，但差异不显著；酶制剂对胰腺消化酶活性影响不显著，显著增加十二指肠和空肠胰蛋白酶、淀粉酶活性，对小肠脂肪酶活性影响不显著；酶制剂对盲肠微生物菌落数影响不显著。

The primary repair and Roux-en-Y duodenojejunostomy and modified Cogbill's techniques for duodenal diverticularization are practical operation.

十二指肠损伤的早期诊断及治疗是至关重要的，十二指肠修补术、十二指肠空肠Roux-en-Y吻合术和改良十二指肠憩室化手术是治疗十二指肠损伤的实用方法。

Early dignosis and treatment for duodenal injury are very important. The primary repair and Roux-en-Y duodenojejunostomy and modified Cogbill's techniques for duodenal diverticularization are practical operation.

十二指肠损伤的早期诊断及治疗是至关重要的，十二指肠修补术、十二指肠空肠Roux-en-Y吻合术和改良十二指肠憩室化手术是治疗十二指肠损伤的实用方法。

The duodenoscopy and the biopsy are the principle methods for the diagnosis of the duodenal tumor; the therapy varies as the location of the tumor differs in such a way that the gastroduodenotectomy is advisable mainly for the tumor above the papilla, the duodenal segmental excision is for the tumor below the papilla, and either the pancreatoduodenectomy or the local excision of the duodenal tumor is to be the choice for the papilla periphery tumor according to the biological property of the tumor itself.

纤维十二指肠镜检查和活检是诊断十二指肠肿瘤的主要方法；肿瘤部位不同，治疗方法亦异，乳头上方肿瘤以胃十二指肠切除为主，乳头下方肿瘤以十二指肠节段性切除为主，乳头周围肿瘤根据肿瘤生物学特性选择胰十二指肠切除或经十二指肠肿瘤局部切除或ESE。

The duodenoscopy and the biopsy are the principle methods for the diagnosis of the duodenal tumor; the therapy varies as the location of the tumor differs in such a way that the gastroduodenotectomy is advisable mainly for the tumor above the papilla, the duodenal segmental excision is for the tumor below the papilla, and either the pancreatoduodenectomy or the local excision of the duodenal tumor is to be the choice for the papilla periphery tumor according to the biological property of the tumor itself.

纤维十二指肠镜检查和活检是诊断十二指肠肿瘤的主要方法；肿瘤部位不同，治疗方法亦异，乳头上方肿瘤以胃十二指肠切除为主，乳头下方肿瘤以十二指肠节段性切除为主，乳头四周肿瘤根据肿瘤生物学特性选择胰十二指肠切除或经十二指肠肿瘤局部切除或ESE。

But we don't care about Battlegrounds.

但我们并不在乎沙场中的显露。

Ah! don't mention it, the butcher's shop is a horror.

啊！不用提了。提到肉，真是糟透了。