胸腹联合伤56例诊治体会

目的探讨胸腹联合伤的特点和诊治方法 ,为临床救治提供参考。方法回顾性分析自2008年6月～2012年6月收治的经手术证实的56例胸腹联合伤的临床资料。其中15例采用开胸手术,23例采用胸腔闭式引流+剖腹手术;18例采用开胸+剖腹手术。结果 56例患者中开放性损伤23例,闭合性损伤33例,术前休克35例;12例漏诊或延误诊断;治愈50例,死亡6例。结论腹联合伤病情复杂,漏诊率及病死率均较高,降低病死率、提高救治水平的关键是早期正确诊断、及时和合理的手术治疗。

Objective To explore the characteristics and treatment of thoraco-abdominal injuries and provide a reference for clinical treatment. Methods 56 cases of thoraco-abdominal injuries were retrospectively analyzed from June 2008 to June 2012, 15 patients were done with open thoracic surgery, 23 patients with pleural closed drainage and laparotomy; 18 patients with open thoracic and laparotomy.Results In 56 cases, 23 cases had open injury, 33 cases had closed injury, 35 cases had preoperative shock, 12 cases were missed or delayed diagnozed; 50 cases cured, 6 cases were dead. Conclusion Thoraco-abdominal injuries is difficult, the missed diagnosis and mortality rates are higher, mortality, it is the key to improve treatment level are the early accurate diagnosis, timely and oroDer surgical management.