腹膜后血肿48例的诊断与治疗

Analysis on diagnosis and treatment of 48 cases with retroperitoneal hematoma

目的探讨创伤性腹膜后血肿的诊断与治疗。方法回顾性分析腹膜后血肿患者临床资料48例。其中行剖腹手术41例(打开腹膜后血肿探查26例),非手术治疗17例。结果本组患者中,治愈45例,死亡3例(6.25%),死亡原因均为大血管损伤致失血性休克。结论CT检查和剖腹探查是确诊腹膜后血肿的有效手段,腹腔穿刺无确定的诊断意义。是否打开血肿探查依据其位置和具体情况决定,操作时应注意良好显露、有效控制,术后充分引流。

Obieetive To discuss diagnosis and treatment of patients with retroperitoneal hematoma. Methods Clinical data of 48 cases with retroperitoneal hematoma were studied retrospectively, Laparotomy were performed in 41 cases as well as conservative treatments in 17 cases. Twenty-six cases in operative group received exploration of retroperitoneal space. Results Forty-five patients were cured,3 died of hemorrhagic shock due to main vessel injury with a mortality of 6.25 %. Conclusion CT and exploratory laparotomy are effective procedures to confirm the diagnosis of retroperitoneal hematoma. Abdominal tap should not be used as a diagnostic method. Decision of exploration for retroperitoneal space is made according to the hemotomds location and condition. Satisfactory exposure, effective control and sufficient drainage all should be emphasized.