创伤后腹腔室隔综合征的诊治分析

Diagnosis and treatment of abdominal compartment syndrome after trauma

目的分析创伤后腹腔室隔综合征(ACS)的临床特点,总结其诊治经验。方法收集2000年8月~2008年3月我科收治的17例创伤后ACS临床资料,分析其发病高危因素、临床分型和治疗措施。结果17例创伤后ACS患者中,6例因胰腺和(或)十二指肠损伤延迟诊断而引起。根据病变部位分型,17例中9例为腹腔型,8例为腹膜后型。17例均行剖腹手术治疗,4例死亡,死亡率23.5%。结论及时处理腹部创伤、减少漏诊、选择适当的休克复苏措施有助于减少创伤后ACS的发生。根据患者损伤情况ACS分型,选择恰当的个体化手术方案有助于降低创伤后ACS的并发症和死亡率。

Objective To investigate the clinical characteristics of abdominal compartment syndrome （ACS） after trauma and explore effective therapy. Methods Clinical data of 17 trauma patients with ACS admitted in our department during August 2000 to March 2008 were collected. The etiology, diagnosis, treatment approaches and outcome of these patients were analyzed. Results Traffic injury and falling injury were the most common causes of ACS after trauma. ACS occurred due to delayed therapy of pancreatic and/or duodenum injury in 6 cases. Nine cases were peritoneal cavity type,8 were post-peritoneal type. All patients underwent laparotomy^and 4 patients died with mortality rate of 23.5%. Conclusion Prompt treatment of abdominal injury and appropriate shock resuscitation may reduce the occurrence of ACS in trauma patients. Personalized therapy according to the classification of ACS may decrease morbidity and mortality rate of ACS after trauma.