腹部损伤合并多发伤临床救治分析

Application of damage control in the abdominal injury with multiple injuries

目的探讨腹部损伤合并严重多发伤的早期诊断和治疗。方法回顾性分析100例腹部损伤合并严重多发伤的诊断和治疗经过。结果Ⅰ期经腹手术80例，经胸腹手术20例；合并伤Ⅰ期手术26例，Ⅱ期手术i9例；治愈91例（91．0％），死亡9例（9．0％），死亡原因合并重型颅脑伤4例（44．4％），严重失血性休克3例（33．3％，术中死亡2例），术后多器官功能衰竭2例（22．2％）。腹部术后并发症为：应激性溃疡29例（29．0％），腹部创口裂15例（15．0％），低营养症25例（25．0％），粘连性肠梗阻18例（18．0％）。结论综合治疗腹部损伤合并严重多发伤可有效降低患者的病死率。

Objective To explore injury control in the abdominal injury with serious multiple injuries in the early diagnosis and treatment level. Methods Retrospectively analyzed 100 patients with abdominal injury with severe multiple trauma diagnosis and treatment for summing up experience. Results Phase Ⅰ results of 80 cases of abdominal surgery,the 20 patients with chest and abdominal surgery,the merger of trauma surgery 26 cases Ⅰ , Ⅱ surgery in 19 eases,cured 91 cases（91.0 % ） ,9 patients died（9.0 % ） ,the causes of death combine severe brain injury 4 csaes（44.4 % ）, severe hemorrhagic shock in 3 cases（33.3 % , deaths in the 2 cases）, multiple organ failure after operation 2 cases（22.2 % ）. Complications after abdominal surgery： stress ulcer 29 cases （29.0 % ）, abdominal wound cracked 15 cases（15.0 % ） ,low-nutrition of 25 cases（25.0 % ）, 18 cases of intestinal obstruction adhesions（18.0 % ）. Conclusion Surgery damage control applications can be effective in reducing the mortality rate in the abdominal injury with serious multiple injuries.