外伤性小肠破裂256例分析

The clinical analysis of 256 cases with traumatic rupture of small intestine

目的进一步提高对外伤性小肠破裂的诊治水平。方法综合国内4家医院1987～1998年间诊治的外伤性小肠破裂256例，并进行回顾性分析。结果并发切口感染20例，切口裂开3例，肠粘连8例，盆腔脓肿1例，肺部感染5例，多器官功能不全综合征（MODS）9例。治愈247例，死亡9例。死亡原因均为合并伤伴创伤性休克或感染性休克，导致MODS。结论早期诊断、及时手术，选择合适的手术方式，彻底的冲洗和合理的引流，早期应用抗生素，重视整体治疗等均为减少并发症、降低病死率的重要因素。

Objective To improve the level of diagnosis and treatment to the traumatic rupture of small intestine.Methods To sum up the 256 cases with traumatic rupture of small intestine at 4 domestic hospitals from 1987 to 1998,and to make an analysis in retrospect. Results 20 cases of complicated cutting infection, 3 cases of cutting split, 8 casesof intestine conglutination, 5 cases of lung infection, 1 cases of pelvic abscess and 9 cases of MODS. Cure: 247 cases,Death:9 cases. The causes of death were all due to joint wound, accompanied by traumatic shock or infectious shock,which resulted in MODS. Conclusion The early diagnosis, prompt operation, suitable operation method, through abdominal washing and proper drainage, early application of antibiotic and great attention to whole treatment, etc, are allimportant factors to reduce the complication and cut down the death rate.