外伤性小肠破裂292例临床诊治分析

Analysis on diagnosis and treatment with 292 patients of traumatic small bowel perforation

目的:探讨早期诊断,早期手术,合理治疗对外伤性小肠破裂治疗效果的影响。方法:对笔者所在3家医院1994年7月～2009年12月治疗的292例外伤性小肠破裂分组进行临床回顾性分析。结果:治愈265例(90.75%),死亡27例(9.25%),并发症发生率为20.20%(59例)。其中,手术时间≤12h209例,治愈202例(96.65%),死亡7例(3.35%),并发症发生率为8.61%(18例);手术时间>12h83例,治愈63例(75.90%),死亡20例(24.10%),并发症发生率为49.39%(41例)。<12h与>12h手术的治愈率、死亡率、并发症发生率经统计学分析,有显著性差异(P<0.05)。结论:早期诊断,早期手术是提高外伤性小肠破裂诊治水平、提高治愈率、降低死亡率的关键。

Objective:To discuss the effect of early diagnosis and early surgical treatment and reasonable therapy with traumatic small bowel perforation.Methods:From July 1994 to December 2009 in three hospitals,292 enterorrhexis patients were divided into groups to analyze retrospectively.Results:265 cases(90.75%) were cured,27 cases(9.25%) died,complication rate was 20.20%(59 cases).Among them,operation time ≤12 h were 209 cases,202 cases were cured(96.65%),7 cases(3.35%) died,complication rate was 8.61%(18 cases).operation time > 12 h were 83 cases,63 cases(75.90%) were cured,20 cases(24.10%)died,complication rate was 49.39%(41 cases).Between operation time≤12 h and >12 h surgery cure rate,mortality rate,complication rate by statistical analysis,there were significant differences(P<0.05).Conclusion:Early diagnosis and early surgiery can improve the level of diagnosis with traumatic small bowel perforation,enhance the curative rate,reduce the mortality rate.