胸腹联合伤79例诊治分析

Diagnostic and therapeutic analysis of 79 cases of thoracic -abdominal injury

目的进一步提高对胸腹联合伤的诊治水平。方法对79例胸腹联合伤为主的多发性损伤进行回顾性分析。结果并发切口感染16例，切口裂开4例，肺部感染21例，肠粘连18例，脑疝5例，应激性溃疡30例，急性呼吸窘迫综合征（ARDS）6例。治愈60例（75．9％），死亡19例。死亡者均为3处以上的多脏器损伤。死亡原因主要是脑疝、ARDS、失血性休克或感染性休克，导致多器官功能障碍综合征（MODS）。结论损伤器官越多，预后越差。早期诊断，及时正确的治疗，早期应用抗生素，重视整体治疗水平等均为提高治愈率，减少并发症，降低死亡率的关键。

Objective To improve the level of diagnosis and treatment to the thoracic - abdominal injury. Methods To sum up the 79 cases with thoracic - abdominal injury, and to make an analysis in retrospect. Results 16 cases of complicated cutting infection ,4 cases of cutting split, 21 cases of lung infection, 18 cases of intestine conglutination,5 cases of herniation of brain,30 cases of stress ulcer, 6 cases of ARDS. Cure ： 60 cases （ 75.9 % ） ; Death ： 19 cases （ 24% ）. All death were multiple organs injuried up to 3 points. Majoy causes of death were due to herniation of brain, ARDS, and bleeding shock or infections shock, which resulted in MODS. Conclusion Prognosis was worse with injuried organs increasing. The early diagnosis, prompt and correct treatment, early application of antibiotic, and great whole the level of treatment, etc, are key to improve the cure rate, reduce the complication, cut down the death rate.