胸腹联合伤的早期诊断和治疗

Early diagnosis and surgical treatment of combined thoraco - abdominal injuries

目的探讨胸腹联合伤的临床特点和早期诊断及治疗经验。方法回顾性分析1998年8月至2006年10月经手术证实的胞腹联合伤26例的临床资料，其中闭合性损伤20例，开放性损伤6例，均合并血、气胸，15例合并休克。结果所有患者均行手术治疗，其中经腹手术14例，经胸手术6例，先剖腹后剖胸3例，先剖腹后开胸2例，胸腹联合切口1例，治愈21例，死亡5例，治愈率80．8％。结论胸腹联合伤病死率高，手术入路应依具体伤情而定，早期正确的诊断和救治．是提高胸腹联合伤治疗效果的关键。

Objective To evaluate the early diagnosis and surgical treatment of thoraco -abdominal injuries （CTI）. Methods A retrospective study was carried out in twenty - six eases of thoraco - abdominal injuries treated surgically from August 1998 to October 2006. Among whom were twenty eases with blunt injury and six eases with peneteating injury, all eases were associated with pneumothorax and/or hemotllorax at various degrees, and fifteen eases complicated with shock. Results Twenty - six eases had operation including fourteen eases with abdominal opertion, six eases with thoracic operation, five eases with thoracic exploration and abdominal operation at the same time, one ease with thoraco - abdominal operation. Twenty - one eases were cured （80.8%） ,five eases died. Conclusion CTI has high mortality rate. The operative approach is based on individual injury condition. Early diagnosis and surgical treatment of complicated thoraco - abdominal injuries are the key to increase therapeutic effect and lower mortlity.