胸腹联合伤48例临床分析

目的探讨胸腹联合伤的特点和诊治方法。方法回顾分析经手术证实的48例胸腹联合伤临床资料。结果开放性损伤21例（占43．8％），以锐器穿刺伤为主；闭合性损伤27例（占56．2％），以交通车祸伤为主；受损器官3个以上23例（占47．9％），术前休克29例（占60．4％）；术前确诊22例（占45．8％），9例漏诊或延误诊断（占18．8％）；治愈40例，死亡8例（占16．7％）。结论胸腹联合伤伤情复杂、严重，休克发生率及死亡率高；膈肌损伤容易漏诊及延误诊断，重视院内急救、及时纠正休克及尽早手术治疗是抢救成功的关键。

Objective To investigate the clinical feature and treatment of thoraco - abdominal combined injuries. Methods 48 cases of clinical data of thoraco - abdominal combined injuries proved by surgery were analyzed retrospectively. Results 21 cases of open injure（43.8% ） priority given to sharp penetrating injury, 27 cases of closed injuries（56. 2% ） priority given to traffic accident injuries, 23 cases of patients with more than 3 damaged organs （47.9%）, 29 cases of preoperative shock （60. 4% ）, 22 cases of preoperative diagnosis（45.8% ）, 9 cases of missed or delayed diagnosis（ 18.8% ）, 40 cases of cure and 8 cases died （ 16. 7% ）. Conclusion Thoraco - abdominal combined injuries are complicated and grave with a high incidence of shock and mortality rate. The misdiagnosis and delay is likely to happen during the injury of diaphragm, emphasis on hospital emergency, the effective correction of shock and surgical treatment as soon as possible are critical for a successful rescue.