创伤性腹膜后血肿75例临床分析

Clinical analysis of 75 patients with tranmafic retroperitoneal hematoma

目的探讨创伤性腹膜后血肿（TRH）的诊断、治疗方法及预后情况。方法回顾性分析75例创伤性腹膜后血肿患者的完整临床资料。结果62例手术患者中死亡5例，占手术患者的8．1％，57例全部治愈。其中1例因刀刺伤导致脾血管断裂、腹主动脉损伤，于术中死于失血性休克，累计失血量达5000ml；1例伴有重度颅脑损伤，死于脑疝。另3例死于术后多器官功能衰竭。13例保守治疗者治愈出院。总体治愈70例，治愈率达93．3％。结论在多发性创伤时应特别注意是否存在创伤性腹膜后血肿，病情允许时可行CT检查明确腹膜后血肿的存在及有无腹腔脏器损伤，准确掌握创伤性腹膜后血肿的治疗原则，严格把握手术指征及腹膜后血肿探查的适应证，以挽救生命，减低病死率。

Objective To explore the diagnosis,treatment and prognosis situation of traumatic retroperitoneal hematoma （TRH）. Methods The full clinical data of 75 patients with TRH were retrospectively analyzed. Results 5 cases of 62 surgical patients died,accounted for surgery patients more than 8. 1%. 57 eases all cured. Including one for knife led to the rupture of the spleen vessel, abdominal aortic injury, surgery died in hemorrhagic shock,the cumulative loss amounted to 5 000ml;1 case with severe traumatic brain injury, died of a cerebral herniation. The other 3 eases died of cancer and multiple organ failure. 13 cases of conservative treatment of all discharged. 70 cases were cured,the cured rate was 93.3%. Conclusion Multiple trauma should pay special attention the existence of TRH. When conditions allowed, CT examination should be taken to clear the presence of retroperitoneal hematoma and the presence of abdominal organ injuries, and accurate knowledge of the principles of TRH treatment, strictly control surgical indications and retroperitoneal hematoma detection indication should be grasped to save Lives and reduce mortality.