胸腹联合伤的早期诊治

目的探讨胸腹联合伤早期诊断和救治方法。方法总结经手术证实的胸腹联合伤24例，其中闭合性损伤20例，开放性损伤4例。结果24例均行手术治疗，经腹手术16例，经胸手术4例，剖腹同时剖胸2例，胸腹联合切口2例，治愈19例，死亡5例，2例死于低血容量性休克，3例死于多器官功能障碍。结论早期正确的诊断和救治，是提高胸腹联合伤治疗效果，降低病死率的关键。治疗原则为先处理胸部损伤，后处理腹部脏器损伤，特别注意避免漏诊膈肌损伤。

Early Diagnosis and Surgical Treatment of Thoraco - abdominal Injuries

Objective To explore the early diagnosis and surgical treatment of thoraco-abdominal injuries.Methods A retrospective study was carried out in 24 cases of thoraco-abdominal injuries treated surgically.Among whom 20 cases with blunt injury and 4 cases with penetreating injury.Results 24 cases had operation including 16 cases with abdominal opertion,4 cases with thoracic operation,2 cases with thoracic exploration and abdominal operation at the same time,2 cases with thoraco-abdominal operation.19 cases were cured,5 cases died,including 2 cases with hypovolemic shock,3 cases with MOF.Conclusion Early diagnosis and surgical treatment of complicated thoraco-abdominal injuries are the key to increase therapeutic effect and lower mortality.The treatment principle is thoracic injury first and laparotomy second.Special attention should be paid to avoid the misdiagnosis of diaphragm injuries.