开放性腹部外伤102例救治分析

Analysis of treatment of 102 cases with opened abdominal injuries

目的探讨开放性腹部外伤的早期诊断和救治方法。方法回顾性总结2001年2月—2011年12月收治的102例开放性腹部外伤患者的临床资料。结果 102例患者治愈98例,死亡4例(2例失血性休克死亡,1例术后腹腔严重感染死亡,1例术后多器官功能衰竭死亡),救治成功率96.1%。结论开放性腹部外伤的救治重点在于早期正确判断是否存在穿透伤、腹腔内脏器损伤及是否需要急诊剖腹探查。应当根据患者受伤过程、腹部体征结合必要的检查来把握剖腹探查指征。一旦发现剖腹探查指征,应尽早手术探查。仔细、全面、有序的剖腹探查是手术成功的关键。开放性腹部外伤腹腔镜探查具有早期诊断、治疗和创伤小、并发症少等优点,但应严格掌握适应证。

Objective To analyze the early diagnosis and treatment of opened abdominal injuries. Methods The data （ from February 200t to December 2011 ） of 102 cases with opened abdominal injuries were summarized retrospectively. Results Among 102 patients, 98 cases were cured, 2 patients died from serious bleeding shock, 1 patient died from postoperative abdominal serious infection, 1 patient died from postoperative MODF. The successful rate was 96.1%. Conclusion The key point of emergency treatment for opened abdominal injuries is early make sure whether penetrating abdominal trauma and intra - abdominal visceral injuries exist and whether needing emergency operation. For the patients with opened abdominal trauma, it should be depended on the injury process, abdominal sign and neeessary examination to deeide whether need exploratory laparotomy. Once the operative indication appears, the patients should be performed operation at once. It is very important for successful operation that comprehensive, careful and sequential exploration. Laparoscope surgery for opened abdominal injuries has many advantages such as early diagnosis and treatment, less trauma and complication, but the surgical indication should be strictly grasped.