严重胸腹部创伤的早期救治

目的探讨总结胸腹部创伤的早期救治方法及临床经验。方法对156例胸腹部严重创伤患者的救治，其中单一部位伤85例（55．1％），多处伤71例（44．9％）。急诊手术36例，其中肝破裂8例，脾破裂行脾切除11例，肠破裂修补及肠系膜破裂修补7例，剖胸探查4例（肺修补，开胸止血）。胸腹联合探查（心脏修补1例，膈肌修补3例。右胸肝膈面枪弹1例）。结果138例一期治愈出院，12例行二期手术（肋骨内固定7例，腹腔脓肿引流2例，颅内慢性血肿1例，骨盆骨折内固定2例）治愈出院，死亡6例。结论早期有效得的救治措施，特别是“120”现场及院前处理（紧急包扎、止血、骨折固定、呼吸道通畅、静脉通道的建立、伤情判断、必要快捷的辅助检查，医院急诊通道等），院内多专科合作对提高严重胸腹部创伤的治疗效果具有重要意义。

Goal： Discusses the total disease settling in the chest abdomen wound the early time to treat and cure the method and the clinical experience.Method： To 156 example chest abdomen serious wound patient＇s treating and curing, in which sole spot wound 85 examples （55.1%） , many place wound 71 examples （44.9%） .Emergency medical treatment surgery 36, in which hepatorrhexis 8 examples, the spleen bursts the good splenectomy 11 examples, intestines breakage patching and the mesentery breakage patches 7 examples, the chest operation investigates 4 examples （lung patching, opens the chest hematischesis） .The chest and belly union investigation （heart patches 1 example, diaphragm patches 3 examples, right chest liver facies diaphragmaticon bullet 1 example） .A result 138 example issue of cure out of hospital, 12 routine two issue of surgeries （in rib fixed 7 examples, abdominal cavity abscess drainage 2 examples, in skull chronic haematoma 1 example, in pelvis bone fracture fixed 2 examples） cure the out of hospital, died 6 examples.Conclusion： The early time results in effectively treats and cures the measure, specially ＂120＂ in front of the scene and the courtyard processes （urgent wrap, hematischesis, bone fracture fixed, respiratory tract unobstructed, vein channel establishment, state of an injury judgment, essential quick assistance inspection, hospital emergency medical treatment channel and so on） , in the courtyard the multi-faculty cooperation to enhances the serious chest abdomen wound the treatment result to have the vital significance.