复合性外伤合并血性腹膜炎保守治疗

Conservative treatment of bloody peritonitis caused by complex trauma

目的 探讨腹腔邻近组织器官复合性外伤引起血性腹膜炎行保守治疗的条件。方法 回顾分析合并血性腹膜炎行保守治疗 2 2例。结果 通过CT检查损伤部位及血腹存在的具体位置 ,观察出血性休克的动态发展 ,行反复多次的腹腔诊断性穿刺及腹腔引流 ,并注意腹围的绝对尺寸、腹膜炎的进展 ,心率、血压的波动、中心静脉压等系列ICU的监护指标 ,以及血常规的动态观察 ,能为临床血性腹膜炎行保守治疗提供参考。结论 正确诊断腹腔邻近组织器官复合性外伤引起微量的血腹 ,并行保守治疗能提高复合外伤的抢救成功率。

Objective To explore the requirement for conservative treatment of bloody perionitis caused by complex trauma of abdominal adjunctive tissue and trauma.Methods The clinical data of 22 cases complicated with bloody peritonitis and accepted conservative treatment were reviewd.Results The trauma sites and location of bloody abdomen were demonstrated by CT scan,the developments of hemorrhagic shock were observed,repeated diagnostic abdominal puncture and drainage were carried out,the changes of abdominal size,heart rate,blood pressure,central venouss pressure,blood routine examination and development of peritonitis were major reference for determination of conservation treatment.Conclusion The success rate of saving complex trauma cases can be increased by correctly diagnosing of trace bloody abdomen causd by complex trauma of abdominal adjunctive tissue and organs and giving conservative treatment.