脊柱骨盆骨折合并腹部闭合伤的早期诊断

Early diagnosis of spine and pelvic fracture complicated closed injury in abdomen

目的 探讨脊柱骨盆骨折合并腹部闭合损伤的诊断方法 ,提高其诊断水平。方法 回顾分析 1980～ 1998年本院收治的 84例脊柱骨盆骨折合并腹部闭合损伤病人的临床资料 ,对比各种诊断方法与手术结果。结果 腹腔穿刺阳性率 82 % ,CT阳性率 74% ,B超阳性率 70 %。 12 h内手术病死率 9.8% ,72 h后手术病死率 36 %。结论 脊柱骨盆骨折合并腹部闭合损伤易发生误诊 ,漏诊。其病死率与手术时机有明显关系 ,腹腔穿刺是一种有效、简便的诊断方法。

Objective To improve the diagnosis of spine and pelvic fracture complicated closed injury in abdomen.Methods The clinical data of 84 case of spine and pelvis fracture complicated closed injury in abdomen between 1980 1998 year were reviewed.Results Positive rate of abdominal puncture,CT and B type ultrasonography was 82%,74% and 70% respectively.The mortality was 9.8% in patients received operation within 12 hours,36% after 72 hours.Conclusions Spine and pelvic fracture complicated abdominal closed trauma facilitated false diagnosis and missed diagnosis,which strongly influenced the mortality.Abdominal puncture is an effective and simple diagnostic method. [