腹部闭合性损伤158例诊治分析

Treatment experience on 158 cases of closed abdomen damage

目的总结闭合性腹部外伤的临床诊治经验,提高闭合性腹部外伤的诊治水平。方法对1993年1月至2003年12月收治158例闭合性腹部外伤的临床资料进行回顾性分析。结果腹腔诊断性穿刺阳性率98.2%,B超诊断阳性率97%,CT诊断阳性率92%。该组158例中,腹腔单个脏器损伤100例,2个脏器损伤40例,3个以上脏器损伤18例,合并脑外伤、胸外伤及多发性骨折57例。150例采用手术治疗。术后死亡13例,死因为广泛性脑挫裂伤、脑干伤、脑疝形成及双肺挫裂伤和急性肾功能衰竭。结论对闭合性腹部外伤的患者,应用综合的诊断方法,做到早期诊断,根据患者具体情况选择恰当的手术方式可有效地减少并发症,降低死亡率。

Objective To sum up clinical experience on closed abdomen trauma and raise its treating level. Methods Carry on retrospective analysis on the 158 cases of closed abdomen trauma accepted by our hospital during January 1993 to December 2003. Results Diagnostic puncture positive rate was 98.2 % ,while ultrasonic diagnosis positive rate was 97 96 and that of computerized tomography was 92 96. In the 158 cases,those with one viscera damage were 100 ,those with two damages were 40 ,and with three or more damages were 18.57 cases were complicated by brain trauma ,chest trauma and frequent fracture. 150 cases were treated by operative treatment with 13 deaths after operation, whose reasons were extensive contusion and laceration of brain, brain stem damage, formation of brain hernia,contusion and laceration of both lungs or acute renal failure. Conclusion Comprehensive diagnosis shall be taken for patients of closed abdomen trauma with early diagnosis and treatment required;Choosing suitable operation according to the circumstance of the patient can effectively decrease complication and death rate.