期刊文献+

严重多发脏器损伤的临床特点及诊治 被引量:20

Diagnosis and treatment of multiple severe injuries
收藏 分享 导出
摘要 目的探讨严重多发脏器损伤的临床特点和诊治方法. 方法对 1988~1998年间收治的合并有闭合性腹内脏器损伤的严重多发伤、ISS大于16的165例患者进行回顾性分析. 结果 3个或 3个以上部位多发伤占28.5%.63例有腹内多脏器损伤.腹腔穿刺是确诊的主要检查手段,部分病例选用了腹部 B超和CT, 3项诊断检查阳性率均在 90%以上.全组漏诊腹内伤21例(12.7%),死亡29例(17.6%).死亡病例平均 ISS 41.6,明显高于非死亡病例 24.8(t=15.21, P<0.01). 结论严重多发伤病例应常规行诊断性腹腔穿刺,酌情选择腹部 B超和CT等检查,以排除腹内脏器损伤.对全身多发伤并存腹内伤的病例,要根据伤情确定急救处理顺序.剖腹手术中要注意多脏器损伤.ISS大于40提示预后不良. Objective To investigate the clinical features and surgical management of patients with blunt multiple severe injuries. Methods 165 patients whth the injury severity score (ISS) over 16 were reviewed between 1988 and 1998. Results 47 cases (28.5%) had 3 or more injury sites, and 63 cases had multiple intraabdominal organ trauma. Abdominal trauma was evaluated by abdominocentesis in 143 cases, by US in 65 and CT in 47. All had positive values over 90%. Missed diagnosis of intraabdominal injury occurred in 21 cases (12 7%). The total mortality rate was 17 6% (29 cases). The average ISS for the died was 41 6 and 24 8 for the survivors ( t =15 21, P <0 01). Conclusion In patients with multiple severe trauma, abdominocentesis is a helpful screening method, US and CT are also among the routine diagnostic measures for intraabdominal injuries. During laparotomy, concomitant organ injuries should be detected with proper care. In patients with multiple severe trauma, ISS over 40 indicates a poor prognosis.
作者 许龙堂 郑樟栋 陈凯 曾天定 吴荣进 吴晓康 俞世安 XU Longtang, ZHENG Zhangdong, CHEN Kai, et al. Department of Surgery, Jinhua Municipal Central Hospital, Jinhua 321000, China
出处 《中华普通外科杂志》 CSCD 北大核心 2001年第9期 525-527,共3页 Chinese Journal of General Surgery
关键词 腹部损伤 剖腹术 临床特点 诊断 治疗 Abdominal injuries Laparotomy
  • 相关文献

参考文献5

二级参考文献3

  • 1Roh JJ,Thompson JS,Harned RK,et al, Value of pneumoperitoneum in the diagnosis of visceral perforation. Am J Surg,1983,146:830. 被引量:1
  • 2Winek TG,Mosely HS,Grount G.et al. Pneumoperitoneum and its association with ruptured abdominal viscus. Arch Surg.1988,123:109. 被引量:1
  • 3Levine MS,Scheiner JD,Rubesin SE,et al. Diagnosis of pneumoperitoneum on supine abdominal radiographs, AJR,1991.156:731. 被引量:1

共引文献73

同被引文献46

引证文献20

二级引证文献77

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈