汶川地震腹部损伤的诊治

Diagnosis and treatment of abdominal injuries after the Wenchuan earthquake

地震腹部损伤所占比例较少。此次汶川地震腹部损伤仅占1．6％，头胸伤占20％左右，70％以上为骨折。主要原因是汶川地震发生在下午，人们处于站立活动体位，直接致伤部位不在腹部。地震伤的黄金救援时间是震后72h以内，但对于合并腹部损伤的伤员，最佳救援时间是伤后6～12h。资料显示地震后24h内救出的伤员占所有幸存者的85％～95％。超过24h后腹部损伤的伤员，尤其是合并腹腔内出血大多已死亡；若合并颅脑损伤，胸部、四肢挤压伤则更难以幸存。

After analyzing the clinical data of 5 injured persons diagnosed with delayed spleen or liver rupture combined with fractures after the Wenchuan earthquake, we found that the abdominal injuries in earthquake were rare but usually very severe. Since almost all the injured persons had multiple injuries, mortality was extremely high. First aid service should be applied in the first 6 to 8 hours. Orderly physical examination and peritoneocentesis in multiple sites are in favor of diagnosis. Reducing the missed diagnosis rate of abdominal injuries is important in raising the rate of successful treatment. Therapy for earthquake injuries should be focused on the most deadly injuries after a thorough examination, besides this, precise employment of control surgery, swift transportation of the injured persons, and prevention and dealing with complications are also important.