46例胸腹联合伤临床分析

Clinical Analysis of 46 Cases of Combined Thoraco-abdominal Injuries

目的分析胸腹联合伤的临床表现特征,总结胸腹联合伤的早期诊断与手术治疗的经验,以降低病死率。方法回顾性分析安庆市第一人民医院1998年-2008年经手术证实的46例胸腹联合伤病例资料,其中开放性损伤17例,闭合性损伤29例,分析不同原因的损伤临床症状与治疗方法。结果46例患者中,治愈38例(82.60%),死亡8例(17.40%),主要并发症包括肺部感染(5例),胸腔包裹积液(4例),膈下感染(1例),腹腔脓肿(1例),均经治疗后痊愈。结论胸腹联合伤病情重,表现复杂;早期诊断,及时合理治疗是减少病死率、提高救治效果的关键。

Objective To investigate the clinical features and early management of combined thoracoabdominal injuries（CTI） in order to improve the treatment and reduce mortality.Methods A retrospective study was carried out in 46 cases of CTI treated surgically from 1998 to 2008,among them 17 cases were with penetrating injuries and 29 cases with blunt injuries.The injuries due to different causes and their clinical symptoms as well as treatment methods were analyzed.Results In 46 cases,38 cases（82.60%） were cured,and 8 cases（17.40%） were died.The main complication include pulmonary infection（5 cases）,pleural effusion（4 cases）,diazoma infection（1 case）,and intra-abdominal abscess（1 case）,and all cases were fully recovered after the treatment.Conclusion Combined thoracoabdominal injuries are critical conditions with complicated clinical manifestations.Early diagnosis and timely surgical intervention is the key to reduce the mortality and improve the cure rate.