腹部闭合损伤脾破裂危险因素

Risk factors in spleen rupture from closed abdominal blunt injury

目的总结腹部闭合损伤脾破裂的临床规律,进一步提高临床疗效。方法对1980年1月～1995年12月我院收治的腹部闭合性损伤而致的269例脾破裂患者入院时13项指标和预后(并发症的发生率和死亡率)的关系进行了分析。结果患者的年龄、全腹肌紧张、肠麻痹、收缩压≤12kPa(90 mmHg)、脉率≥100次/分和同时合并2个以上其它脏器的损伤等6项是腹部闭合损伤脾破裂的危险因素。结论重视老龄人腹部外伤后的病理生理特点、积极防治休克、重视合并伤的治疗是减少腹部闭合损伤脾破裂并发症发生率和死亡率的重要环节。

Objective To summarize the regular clinical pattern of spleen rupture from closed ab- dominal blunt injury and to decrease the morbidity and mortality.Method Two hundreds and sixty- nine patients of spleen rupture from closed abdominal blunt injury treated in our hospital from Jan.1980 to Dee.1995 were analyzed and the relation between 13 signs found at admission and prognosis(mor- bidity and mortality)was studied.Results The patients' age,whole abdominal muscular tension,en- teroparalysis,systolic pressure≤12 kPa(90 mmHg),pulse rate≥100 per minute and two or more than two other damaged organs were the risk factors in spleen rupture from closed abdominal blunt in- jury.Conclusion Paying attention to pathophysiologic changes after abdominal injury in the elderly, prevention and treatment of shock,attaching importance to treatment of concurrent damage are impor- tantlinks for decreasing morbidity and mortality in spleen rupture from chosed abdominal blunt injury.