空肠

Fifteen patients underwent operation, including gastrostomy (6 cases), gastrotomy (4 cases), partial gastric fundus resection (2 cases), others operations (2 case), and laparotomy exploration (1 case); among them four patient died.

手术治疗15例，包括胃切开减压、胃造口术（6例），胃切开减压后再缝合创口（3例），胃切开减压、胃造口、空肠造口术（1例），胃底部分切除术（2例），十二指肠空肠吻合术（1例），空肠造口术（1例），开腹探查术未切开胃壁（1例），死亡4例(26.7%)。

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。

Standing by jejunum to break upright point, seaming stitch to fastening velar predestined relationship, the needlework that be the same as a root is in be apart from jejunum to break upright 6cm place to seam stitch; is velar predestined relationship seams stitch next, the needlework that be the same as a root is in be apart from jejunum to break upright 6cm place to seam stitch, loose loose ligate two silk thread, make jejunum retroflexions 3cm, the mucous membrane that retroflexion the face uses electric bright or carbolic acid tries to destroy, make its are lost secrete a function.

在靠近空肠断端处，在对系膜缘缝一针，同根针线在距空肠断端6cm处缝一针；然后在系膜缘缝一针，同根针线在距空肠断端6cm处缝一针，松松结扎两根丝线，使空肠翻转3cm，将翻转的黏膜面用电灼或石炭酸加以破坏，使其丧失分泌功能。

Three types of reconstruction procedures, including Orr-type Roux-en-Y esophagojejunostomy, P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy, were performed.

全胃切除后消化道重建分别采用全胃切除术后消化道重建Orr式Roux-en-Y食管空肠吻合术、P型空肠袢食管空肠Roux-en-Y吻合术和远端空肠反口贮袋的Roux-en-Y食管空肠吻合术。

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 case number of duodenopancreatectomy,cholecystojejunostomy, cholecystoduodenostomy, gastrojejunostomy, cholecystostomy, choledochoduodenostomy, choledochjejunalostomy, exploration of the common bile duct, and T tube drain were 43, 20, 3, 19, 4, 4, 21, 18, 7 respectively.

行胰十二指肠切除术43例，胆囊空肠吻合术20例，胆囊十二指肠吻合术3例，胃空肠吻合术19例，胆囊造瘘术4例，胆总管十二指肠吻合术4例，胆总管空肠吻合术21例，胆总管探查、T管引流18例，剖腹探查术7例。

The BJ patients were subdivided into cholecystojejunostomy group (n=56) choledochojejunostomy group (n=330), gastrojejunostomy group (n=32) and no-gastrojejunostomy group (n=57) according to the different methods of anastomosis.

BJ组根据吻合方式再分为胆囊空肠吻合组（56例），胆管空肠吻合组（33例）；是否附加胃空肠吻合又分为BJ+胃空肠吻合组（32例），BJ未附加胃空肠吻合组（57例）。

The BJ patients were subdivided into cholecystojejunostomy group(n=56)、 choledochojejunostomy group(n=33), gastrojejunostomy group(n=32) and no-gastrojejunostomy group(n=57) according to the differen methods of anastomosis.

BJ组根据吻合方式再分为胆囊空肠吻合组(56例)，胆管空肠吻合组(33例)；是否附加胃空肠吻合又分为BJ+胃空肠吻合组(32例)，BJ未附加胃空肠吻合组(57例)。

02 D. However, there were more gastrointestinal complications in the jejunostomy group including of abdominal distention (61.5%) and abdominal pain (69.2%) when compared to the non-jejunostomy group.

具有C级程度营养不良人数分别在空肠造口组占9.1%（1人）及无空肠造口组占28.6%（4人）。而A级之人数在空肠造口组占36.4%（4人）、无空肠造口组为35.7%（5人）。

Methods Forty patients with hepatobiliary and pancreatic diseases undergoing biliojejunostomy or cystojejunostomy were randomly divided into seromuscular layer anastomosis group (n=20) and two-layer anastomosis group (n=20) before operation, which received Roux-en-Y end-to-side jejunal seromuscular layer anastomosis and two-layer anastomosis, respectively.

行胆管空肠Roux-en-Y吻合的患者随机分成2组：浆肌层吻合组(n=20)和二层吻合组(n=20)，浆肌层吻合组行Roux-en-Y袢处空肠－空肠浆肌层吻合，二层吻合组行Roux-en-Y袢处空肠－空肠二层吻合。

On the other hand, the more important thing is because the urban housing is a kind of heterogeneity products.

另一方面，更重要的是由于城市住房是一种异质性产品。

Climate histogram is the fall that collects place measure calm value, cent serves as cross axle for a few equal interval, the area that the frequency that the value appears according to place is accumulated and becomes will be determined inside each interval, discharge the graph that rise with post, also be called histogram.

气候直方图是将所收集的降水量测定值，分为几个相等的区间作为横轴，并将各区间内所测定值依所出现的次数累积而成的面积，用柱子排起来的图形，也叫做柱状图。