创伤性腹膜后血肿延误诊断的原因与治疗

Study of the causes of delayed, missed diagnosis and treatment of traumatic retroperitoneal hematoma

目的 探讨创伤性腹膜后血肿 (RH)延误诊治的原因 ,以提高诊治水平。方法 回顾性分析最近 3年 2 2例创伤性腹膜后血肿的临床资料。结果 2 2例创伤性腹膜后血肿术前确诊 6例 ,术前延误诊断的原因是RH无特征性临床表现 ,并常为所合并脏器损伤的症状掩盖。结论 腹部损伤患者经复苏后仍有不明原因的内出血征象时 ,应高度警惕RH的可能、B超对其诊断意义大、剖腹探查的指征宜放宽。

Objective To improve diagnosis and treatment of traumatic retroperitoneal hematoma (RH) throug investigating it's reasons for delayed, missed diagnosis and treatment. Methods Analysing the clinical material in 22 cases of RH retrospectively. Results Of the 22 patients of RH, there are only 6 cases being diagnosed preoperatively. The reasons for this are that the clinical prensentations of RH show no characteration and RH is often concealed by symptoms of injured visera. Conclusions After consciousness is established in patients with abdomen injured, when interal hemorrhage is observed without knowing the reasons, there should be highly alert the possibility of RH. B ultrasound has greatly signicance in diagnosis of RH, and the indications for laparotomy ought to be extended appropriately. For different positions of RH, there should be different management in operation accordingly.