闭合性腹外伤小肠破裂的急诊诊疗诊治探讨

Exploration of mergency diagnosis and treatment of small intestine rupture in closed abdominal trauma

目的:探讨闭合性腹外伤小肠破裂的急诊诊疗和诊治方法.方法:选取宁夏回族自治区银川市第一人民医院2013-01/2015-12收治的闭合性腹外伤小肠破裂患者83例作为研究对象,分析其误诊和漏诊的主要原因.结果:1首次诊断中,共有30例在损伤后并未在第一时间确诊,诊断差错率约为36.14%.2所有患者均痊愈出院,无死亡病例,其中有5例术后并发腹腔水肿,12例伤口感染,2例粘连性肠梗阻,术后并发症发生率为22.89%,均经治疗后痊愈.结论:结合患者的疾病史、全面体检和辅助检查等方式,对病情进行准确评估,为手术治疗提供依据,促进患者的预后.

AIM： To explore the emergency diagnosis and treat- ment of small intestine rupture in closed abdominal trauma. METHODS： A total of 83 patients with small intestinal rupture admitted into the First People＇s Hospital of Yinchuan, the Ningxia Hui Autonomous Region from January 2013 to December 2015 were selected as study objects, and the main causes of misdiagno- sis and missed diagnosis were summarized. RESULTS： （1）In the first diagnosis, a total of 30 patients after the injury were not con- firmed in the first time, the diagnostic error rate was about 36. 14%. （2）All the patients were recovered and discharged, no deaths, including 5 cases caused by abdominal cavity after oede- ma, 12 cases of wound infection, 2 cases of adhesion sex intesti- nal obstruction, the incidence of postoperative complications was 22.89%, all healed after treatment. CONCLUSION： Combined the patient＇s medical history with comprehensive physical examina- tion and auxiliary examination way, an accurate evaluation of the disease is made and will provide the basis for the surgical treat- ment and also promote the prognosis of patients.