腹部创伤的救治及并发症的处理

Treatment of abdominal wounded and complications

目的探讨以腹部创伤为主的多发伤的急诊救治及并发症的处理。方法符合以腹部创伤为主的多发伤诊断标准93例伤者,创伤严重度评分(ISS)≥16。对患者及时进行各项检查以确诊创伤部位及伤害程度。有必要时行急诊腹部手术等。其主要并发症包括创伤性休克、感染、肝或肾功能衰竭、弥漫性血管内凝血、下肢静脉血栓形成等。结果 93例中抢救成功76例,其中临床治愈59例(63.4%),残疾17例(18.3%),死亡17例(18.3%)。结论以严重腹部创伤为主的多发伤的诊治应做到边抢救、边诊断、边抢救。对其诊断步骤力求快速、简洁及准确,尽量避免误诊和漏诊。确定抢救的先后次序以及采用的医疗技术非常重要,对并发症应引起足够重视并及时处理,这些均可有效提高抢救成功率。

Objective To discuss the treatment of abdominal wounded and complications.Methods Ninety-three cases of abdominal wounded,the injury severity score（ISS） of them were all over 16.Different examnations were taken to diagnose the wounded sites and damage situation.Emergency abdominal surgery were treated when it was necessary.The main complications included traumatic shock,infection,liver or kidney failure and disseminated intravascular coagulation,lower limb vein thrombosis,etc.Results Seventy-six cases were cured,59 cases were disability,17 cases were dead.Conclusion The diagnosis and treatment of severe abdominal wounded should be rescued,diagnosed and rescued in the same time.The diagnos should be fast,concise and correctly,in order to avoid misseddiagnosis and misdiagnosis.It is important that determine the sequence of rescue and adopting the medical technology.Complications should be payed enough attention and handle in time.The rescue would be successed after the measures were taken.