外伤性小肠破裂68例诊治体会

目的探讨提高外伤性小肠破裂早期诊断水平和选择合适的治疗方式.方法总结68例因车祸致小肠破裂病例的临床诊断与手术治疗体会.结果本组治愈66例,死亡2例.并发切口感染10例,肠粘连5例,盆腔脓肿1例,肺部感染4例,多器官功能障碍综合征(MODS)2例.结论早期诊断,及时手术,选择合适的手术方式,彻底冲洗和合理的引流,早期应用抗生素,重视整体治疗水平等,可减少并发症(术后感染是其主要并发症)和降低病死率(致死原因主要为小肠瘘和MODS).

Diagnosis and treatment of 68 patients with traumatic rupture of small intestine

Objective To increase the accuracy of early diagnosis and choose a suitable management of the traumatic rupture of small intestine.Methods Clinical material of 68 cases with traumatic rupture of small intestine from 1990.1 to 2000.12 in our hospital were reviewed.The main cause of injury was traffic accidents.All patients were treated with operation.Results There are complicated infection of incision wound in 10 cases,intestine adhesion in 5 cases,pelvic abscess in 1 cases,lung infection in 4 cases and MODS in 2 cases.Sixty six cases were cured,2 cases died.Conclusion Early diagnosis,prompt operation,suitable operation method,abdominal washing,proper drainage,early application of antibiotic and great attention to overall treatment are important to reduce the complication(mainly intestinal fistula and abdominal abscess) and cut down the death rate(the cases of death were all due to intestion fistula and MODS).