地震灾害致腹部创伤的诊治体会

Diagnosis and treatment of abdominal injuries arising from the 2008 Wenchuan earthquake

目的研究特大地震灾害所导致的腹部外伤的分类和预后,总结其救治经验。方法2008年5月12日至22日江油市903医院收治589例地震伤者中24例(4.1%)合并腹部伤,对其伤情资料进行统计分析。结果24例腹部伤中,3例由于严重的胸腹伤在运送至医院途中或到院即死亡,21例收治住院,5例由于严重胸、腹部伤或颅脑损伤在入院后12h内死亡,总病死率33.3%。常见的腹部伤是腹壁挫伤、腹膜后血肿、脾破裂、肝挫裂伤。所有伤者均合并软组织损伤,23例(95.8%)合并其他重要脏器损伤。存活伤者16例,经及时积极救治,预后良好。结论早期甄别伤情、明确诊断,积极抗休克,选择恰当的治疗方式,及时处理合并伤可以有效降低病死率。

Objective To study the prognosis and the types of abdominal injuries that are likely to occur following a major earthquake, and summary the experience of treatment of abdominal injuries following the earthquake. Methods The medical records of 589 patients with injuries who were referred to 903 hospital from May 12 to May 22 were reviewed. Of the 589 patients, 24（4. 1%） were found to have abdominal injuries. Results Of these 24 cases, three patients with severe abdominal and chest injury were dead on arrival at the hospital. The remaining 21 patients were admitted to our hospital. Five patients were dead because of severe abdominal and/or brain injury in the hospital within 12 h. The mortality rate was 33.30//00. The more common type of abdominal injury was contusion of abdominal wall,followed by retroperitoneal hemotoma, splenic rupture, and liver laceration. All of them were combined with soft tissue injuries, and 23 patients（95. 8%） with other major organ injuries. Sixteen patients with a positive and timely treatment were survival and prognosis is good. Conclusion The way to decrease the mortality is early treatment of abdominal injury, the treatment of the other systems injuries and the treatment of shock.