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腹部手术后腹腔内出血的诊治(附26例报告)
引用本文:邱法波,吴力群,王豪夫,张顺,张炳远,张斌,杨金镛.腹部手术后腹腔内出血的诊治(附26例报告)[J].青岛大学医学院学报,2003,39(3):253-254.
作者姓名:邱法波  吴力群  王豪夫  张顺  张炳远  张斌  杨金镛
作者单位:青岛大学医学院附属医院肝胆外科,山东,青岛,266003
摘    要:①目的 总结腹部手术后腹腔内出血的诊治经验。②方法 对 1981年 1月~ 2 0 0 1年 9月腹部手术后 2 4h内腹腔内出血 >30 0mL的 2 6例病人进行回顾性分析。肝癌切除术 9例 ,脾切除加断流术 7例 ,腹膜后肿瘤切除术和直肠癌Mile手术各 3例 ,胰头十二指肠切除术 2例 ,其他手术 2例。③结果  14例再手术治疗 ,12例非手术治疗 ,死亡 7例 ,腹腔内出血量 >30 0 0mL的 6例病人均死亡 ,出血量 10 0 0~ 30 0 0mL的 11例病人死亡 1例。④结论 腹部手术后出血但生命体征稳定者 ,可在严密监测下非手术治疗。术后 2 4h内出血量 <6 0 0mL或累计出血量 <10 0 0mL可作为非手术治疗的参考指标。对于创面广泛渗血或不能清楚显示出血部位者 ,应用长纱布条压迫止血是有效的方法

关 键 词:腹部手术  手术后  腹腔内出血  诊断  治疗  外科手术
文章编号:1672-4488(2003)03-0253-02
修稿时间:2003年2月18日

THE DIAGNOSIS AND TREATMENT OF INTRA-ABDOMINAL BLEEDING OF POST-ABDOMINAL OPERATION: A REPORT OF 26 CASES
QIU Fa bo,WU Li qun,WANG Hao fu,et al\.THE DIAGNOSIS AND TREATMENT OF INTRA-ABDOMINAL BLEEDING OF POST-ABDOMINAL OPERATION: A REPORT OF 26 CASES[J].Acta Academiae Medicinae Qingdao Universitatis,2003,39(3):253-254.
Authors:QIU Fa bo  WU Li qun  WANG Hao fu  \
Abstract:Objective\ To summarize the experience in the diagnosis and treatment of intra abdominal bleeding after abdominal operation. \ Methods\ From Jan. 1981 to Sept. 2001, 26 cases of intra abdominal bleeding, over 300 mL, within the first 24 hours after operation, were analyzed retrospectively. The initial operations were: hepatectomy for liver cancer in 9 patients, splenectomy and devascularization for portal hypertention in 7, resection of retroperitoneal tumor in 3, Mile operation for rectal cancer in 3, pancreatoduodenectomy in 2 and other operations in 2.\ Results\ Re operations were done in 14 cases and 12 cases treated conservatively. Seven died. Six cases with blood loss of more than 3 000 mL all died, for 11 cases whose blood loss was 1 000 to 3 000 mL, one died.\ Conclusion\ Patients with stable vital signs could be treated non surgically under intensive monitoring. The blood loss less than 600 mL within 24 hours after operation or the accumulative blood loss of less than 1000 mL could be taken as reference parameter for conservative therapy. For diffuse oozing or the bleeding site that can not be exposed clearly, long ribbon gauze plugging is an effective way to control bleeding.
Keywords:surgery  digestive system  hemorrhage  complications  abdominal neoplasms
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