胸腹联合伤的诊断与治疗30例

Diagnosis and surgical treatment of 30 cases with thoracoabdominal injury

目的总结胸腹联合伤的早期诊断与手术治疗经验。方法对我院2002年3月至2008年10月收治的30例胸腹联合伤患者采取回顾性分析的方法，对不同的损伤类别及不同的临床症状和手术方式进行分析。结果剖胸加剖腹手术10例，胸腔闭式引流加剖腹手术20例，治愈27例，死亡3例，其中1例死于失血性休克，1例死于严重创伤引起的多器官功能障碍综合征，1例死于成人呼吸窘迫综合征。本组并发症有肺部感染4例，创口感染3例，粘连性肠梗阻2例。结论胸腹联合伤伤情复杂、危重，最常见的死因为失血性休克。早期手术和恰当地选择手术方式是提高危重胸腹联合伤患者抢救成功的关键。

Objective To investigate the clinical features and management of combined thoracoab- dominal injury. Methods Date of 30 patients with thoracoabdominal injuries were analysed retrospectively. Results Ten patients received thoracoabdominal operation and 20 patients were given thoracic closed drainage plus abdominal operation,27 patients were cured,3 patients died, 1 patient died of hemorrhagic shock, 1 patient died of MODS caused by severe injuries and 1 patient died of ARDS. Conclusions Thoracoabdominal injuries are severe and complicated injuries and the most frequent cause for mortality is hypovelemic shock. Early operation are the key steps in reducing the mortality in severe thoracoabdominal injuries.