车祸伤小肠破裂40例诊治分析

Analysis of the diagnosis and treatment of small intestinal rupture caused by traffic accident in 40 cases

目的提高因车祸致小肠破裂的诊治水平。方法对我院1994年1月-2004年12月诊治的因车祸引起小肠破裂的40例患者进行回顾性分析。结果所有患者均有不同程度的腹痛和腹膜刺激征,腹穿阳性率为75%,X线检查提示膈下游离气体阳性率62.5%,CT检查提示腹腔积液阳性率75%。患者治愈39例,死亡1例。结论①早期诊断车祸致小肠破裂的关键是必须结合病史、阳性体征、临床表现及辅助检查进行综合分析。②早期手术治疗是提高车祸致小肠破裂治愈率的关键。③手术探查必须全面、仔细,按顺序进行,避免漏诊。

Objective To improve the level of diagnosis and treatment with small intestinal rupture caused by traffic accident. Methods From January 1994-December 2004,40 cases with small intestinal rupture caused by traffic accident were analyzed retrospectively.Results All the patients had different degree of abdominal pain and peritoneal irritation sign. Abdominal puncture nositive rata was 75%. X-ray examination showed the positive rate of subdiaphragmatic free air which was 62.5%. CT scan showed hydrops abdominis positive rate was 75% .39 cases were cured and 1 case died.Conclusion ①It is very important to make early diagnosis of small intestinal rupture caused by traffic accident which were neccesary to combine with history, positive signs, clinical manifestation and auxiliary examinations. ② Early operation is the key to increase the cure rate of small intestinal rupture. ③For avoiding the intraoperative missed diagnosis, operative exploration should be careful,overall and according to the certain sequence.