创伤性腹膜后大血肿81例临床报告

Large Retroperitoneal Hematoma Caused by Trauma: A Report of 81 Cases

本文报道我院创伤性腹膜后大血肿81例。致血肿的原因骨盆骨折占首位,内脏伤次之,大血管伤仅6例。本文将血肿分成特大、巨大和较大型三种,有助于对伤员预后的判断。其诊断主要应除外内脏损伤,除一般体征外,腹穿、X线、超声等有助于诊断。本组病例手术探查率高,术后并发症和后遗症少,死亡率低。

Eighty-one patients with large retoperitoncal hematoma due to trauma are reported. Nature of hematomas are attributable to fracture of pelvis in more than half of the cases (55%), then to be followed by visceral injuries (34.6%) and injury to great vessels(11%). The hematomas may be classified into three categories according to their size which is believed to be useful in evaluating prognosis, Caution should be paid to ascertain any coexisting visceral injuries. Abdominal paraeentesis, X-ray and ultrasonic examinations are found conducive to the diagnosis besides clinical signs. The key points in the treatment is that whether surgical intervention is mandatory. Abdominal exploration as a must should be undertaken for those who have epigastric hematomas, or hematomas of very large size. Operation should be done selectively in those with large peritoneal hematomas. The operation is definitely not a routine choice of treatment and should be handled with caution for patients with large pelvic hematoma due to fracture of pelvis,