以腹部伤为主的多发伤62例救治体会

Managing Experience of 62 Patients Whose Abdominally Injury Combined With Multiple Injuries

目的：探讨以腹部伤为主的多发伤的诊断和治疗方法．方法：回顾性分析 １９９９年 １月～２０００年 １２月，收治的６２例以腹部伤为主的多发伤患者，对其诊断、治疗方法及结果进行总结评价．结果 诊断性腹穿、Ｂ超、ＣＴ的诊断阳性率各为９８．０％、８８．１％、８０．８％．腹部伤中肝、脾破裂占７４．２％，合并伤中颅脑及胸部损伤占５８.１％．全组均手术治疗．手术死亡 １３例（２０．９％）主要死亡原因为失血性休克、ＭＯＦ、ＡＲＤＳ．结论 早期诊断，迅速有效地手术治疗，严防并发症发生，是多发伤救治的主要措施．

Objective: To study diagnostic steps and management of abdominal injury combined with multiple injuries. Methods: The retrospective analyses of 62 treated patients whose abdominal injury with multiple injuries from January 1994 to December 2000 were carried out and finally made an evaluation and summary to treating methods and effects. Results: Positive rate of peritoneal puncture, B-ultrasonography and CT were 98.0%, 88.1% and 80.8% respectively. Among those cases, liver and spleen injuring proportion was 74.2% and combining injuries 58.1% for cranial injury or thoracic trauma. Whole group underwent operation management, 13 patients died (20.9%). The main reasons of death were hemorrhagic shock, MOF or ARDS. Conclusion: To diagnose early as soon as give effective operating management and prevent complication from happening strictly could be main measure for saving patients with multiple injuries.