老年人腹部创伤的临床特点及诊治对策

Clinical Features and Strategy of Diagnosis and Treatment of the Abdominal Trauma in Elder People

目的 探讨老年人腹部创伤的临床特点及诊治对策。方法 回顾性分析 68例老年人腹部创伤患者的临床病例资料。结果 伤后 12h内确诊 3 5例 ( 51.5% )。 68例中 58例行手术治疗 ,10例采用非手术治疗 ,死亡 7例 ,死亡率为 10 .3 % ,死亡原因有感染性休克、多器官系统功能衰竭 (MOSF)等。结论 老年人腹部创伤患者的临床病理生理特点有其特殊性 ,且对创伤的耐受性差 ,伤后临床表现不明显 ,易发生误诊或漏诊。因而应根据其损伤特点与病情轻重 ,正确地选用辅助检查 ,综合分析 ,尽早诊断。处理原则首选手术治疗 ,重视围手术期处理 ,保护各重要脏器功能 ,防治多器官功能障碍综合征 (MODS)。

Objective To investigate the clinical features and strategy of diagnosis and treatment of the abdominal trauma in eld er people. Methods Clinical data of 68 elderly patients w ith abdominal trauma were analyzed retrospectively.Results Diagnosis in 35 of 68 cases were confir med within 12 hours after trauma (51.5%). Fifty-eight cases in this group were treated surgically and 10 cases with non-surgical treament.The re were 7 death, the overall mortality was 10.3% . The cause of death was septic shock and multiple organ systemic failure. Conclusion The elder patient with abdominal tra uma has its speciality in clinical and pathophysiological characteristics and is less tolerant to trauma, which easily leads to misdiagnosis or maldiagnosis. T he principle of treatment is to choose positive surgery, to streng then the peri operative management, to protect the function of each important organ, and to pr event the occurrence of multiple organ dysfunction syndrome.