腹部穿透性损伤(附59例报道)

目的 :探讨如何提高腹部穿透性损伤的诊疗水平。方法 :对 5 9例腹部穿透性损伤临床资料进行回顾性分析。本组行单纯清创缝合术 17例 ,其中 4例中转剖腹手术 ;即时行剖腹探查术 4 2例 ,其中单纯性腹壁穿透伤 5例 ,合并腹腔脏器损伤 37例。结果 :全组治愈 5 7例 ,2例死于失血性休克。 8例发生伤口感染 ,1例并发胰漏。结论 :早期正确诊断是提高腹部穿透性损伤救治成功率的关键。积极抗休克和及时剖腹探查是改善预后的根本措施。在严密观察下 ,合理选择病人行单纯清创缝合术是安全可行的。

The Diagnosis and Treatment of Penetrating Injury in Abdomen(a Report of 59 Cases)

Objective:To improve the level of diagnosis and treatment of penetrating injury in abdomen.Methods:The clinical data of 59 cases with penetrating injury in abdomen were analysed retrospectively.17 cases were treated by the simple debridement and stitching, 4 of whom turned to the laparotomy later. 42 cases underwent immediate laparotomy; the simple penetrating injury in abdominal wall was detected in 5 cases and the organ injury in abdomen in 37 cases.Results:57 cases were cured, 2 cases died of hemorrhagic shock; wound infection occurred in 8 cases and pancreatic fistula occurred in 1 case.Conclusions:Early and correct diagnosis are essential in increasing the success rate of emergency treatment of penetrating injury in abdomen. Active resuscitation and timely laparotomy can improve the curative effect. It is safe and feasible to perform simple debridement and stitching for certain patients under observation.