腹部闭合性损伤早期诊断的难点及对策

Diagnosis difficulties and countermeasures of blunt abdominal injury

目的:总结腹部脏器闭合性损伤的诊治方法,提高腹部闭合性损伤的诊疗救治水平。方法:回顾性分析169例腹部脏器闭合性损伤患者的诊治情况,总结相关的经验和教训。结果:169例腹部闭合性损伤患者中,腹腔穿刺检查、B超、CT及X线检查阳性率分别是91.1%、92.3%、91.8%及34.3%。结论:腹腔镜检查对腹部闭合性损伤诊治是一种积极、微创、有效的诊疗方法。及时地腹腔穿刺和必要的B超检查是简单、安全、有效的诊断方法。合理的CT和X线检查具有较高的诊断价值。选择性水溶性造影剂消化道造影可进一步明确十二指肠或结直肠损伤的诊断。腹腔镜技术为闭合性腹部损伤的早期诊断及处理提供了又一科学手段。

Objective To summarize the methods of diagnosis and treatment of abdominal organs blunt injury in order to improve the level of diagnosis and treatment.Method 169 cases diagnosed as blunt abdominal injury in our hospital among six years were included in the study and had a retrospective analysis.The experience and lessons were summarized.Results In 169 cases of patients with blunt abdominal injury,the positive rate of the abdominocentesis,ultrasonography,CT and X-ray examination were 91.1%,92.3%,91.8% and 34.3% respectively.Laparoscopy for diagnosis and treatment of blunt abdominal injury was a positive,minimally invasive,effective treatment method.Conclusion The timely abdominal puncture and B-ultrasound were simple,safe and effective diagnostic method.CT and X-ray examination had a high diagnostic value.Selective water-soluble contrast agents gastrointestinal contrast could further clarify the diagnosis of duodenal or colorectal injury.Laparoscopic techniques provided another scientific means for the early diagnosis and treatment of blunt abdominal injury.