交通事故致闭合性腹部损伤473例临床分析

总结20年来收治的473例交通事故引起的闭合性腹部损伤者病例资料，分析道路交通事故致伤力学特点及体征与快速诊断关系，探讨治疗方法的选择。     

交通事故致腹部闭合伤91例诊治分析

目的总结91例交通事故致腹部闭合伤的诊治经验。方法91例均腹腔穿刺,阳性率96.7％;床旁B超检查83例,阳性率91．2％;CT检查47例,阳性率100％。结果手术治疗78例(85.7％),其中1例术中死于失血性休克。非手术治疗13例(17．6％),均痊愈。结论对交通事故致闭合性腹外伤的诊断与治疗应争分夺秒,灵活运用各种检查方法,迅速判断病情并制定相应诊治方案,以挽救患者生命。     

交通事故致腹部钝性伤94例临床分析

回顾分析94例交通事故致腹部钝性损伤病人的临床资料.非手术治疗18例,手术76例;1次手术治疗者67例(88.1%),2次以上手术者9例(11.8%);死亡6例,死亡率6.4%.关注其他明显外伤的同时,细致检查和严密动态观察腹部情况是早期诊治、提高治愈率、降低死亡率的关键.     

腹部闭合性损伤致小肠破裂60例临床分析

回顾性分析60例腹部闭合性损伤致小肠破裂的诊治效果,认为早期诊断、早期手术是挽救病人生命的决定性措施。     

道路交通事故腹部伤的急诊处理

目的 探讨交通事故腹部伤的优化急诊处理方法。方法 回顾性分析了１２７例交通事故腹部伤患者的急诊处理资料。结果 １２７例伤者均行手术治疗,其中闭合伤１２４例均行腹腔穿刺。本组治愈１１３例,死亡１４例,无１例漏诊,误诊。结论 对交通事故腹部伤患者的急诊处理应注意如下几点。（１）详尽的体检和病史采集;（２）对休克,脊柱损伤及重型颅脑损得应警惕腹内伤的可能。（３）慎重选择辅助检查,对疑有腹内伤者首选腹腔穿     

腹部闭合性损伤的诊断和治疗进展

腹部闭合性损伤的特点常为多个脏器受伤伴有大量内出血和休克。据Ａｎｄｅｒｓｅｎ综合各家意见：腹部闭合性损伤的死亡率高达２０％～３０％。处理复杂，涉及问题很多，其治疗效果直接反映了抢救水平和经验。笔者对腹部闭合性损伤诊断和治疗技术的进展综述如下。一、诊断...     

腹部闭合性损伤的诊断及非手术治疗

非手术治疗（NOM）腹部闭合性损伤在现代外科中很常见且已成为标准治疗方法之一,它得益于现代影像学技术的发展、重症监护的应用及临床工作的总结。对于血流动力学稳定的病人,不论年龄大小、器官损伤的程度,通过非手术治疗一般均可获得良好的疗效;而对于血流动力学不稳定和体格检查发现有急腹症或腹膜炎的病人则应进行手术治疗。非手术治疗应该严格掌握适应证,减少不必要的剖腹手术。     

超声诊断腹部闭合性损伤的临床价值

1997年 1 2月— 2 0 0 1年 1 2月 ,笔者对收治的 2 37例腹部闭合性损伤 ,行急诊超声检查与手术对照分析 ,现将结果报告如下。1　临床资料1 1　一般资料　本组 2 37例病员 ,男 1 5 3例 ,女 84例。年龄 6～ 75岁 ,平均年龄 37 8岁。受伤原因 :车祸伤 1 74例 ,高处坠落伤 6 3例。症状多有剧烈腹痛、腰痛、甚至休克。但有 3例没有任何腹部不适表现。受伤后就诊时间0 5～ 72ｈ。1 2　使用仪器　日本ＡｌｏｋａＳＳＤ 6 30型和美国百胜Ａｕ 5型超声诊断仪 ,探头频率 3.5ＭＨｚ。1 3　检查方法　患者取平卧位 ,左、右侧卧位及俯卧位 ,进行常规…     

交通事故致闭合性腹部损伤473例临床分析

总结20年来收治的473例交通事故引起的闭合性腹部损伤者病例资料,分析道路交通事故致伤力学特点及体征与快速诊断关系,探讨治疗方法的选择.     

交通事故颅脑伤临床分析

车祸颅脑伤伤情严重,复杂多变。应检查全面与重点相结合,强调动态观察,抢救掌握轻重缓急及多科配合,可提高抢救成功率。     

Assessment of the responsibility between a road traffic accident and medical defects after the traffic accident injury of knee joint

A 48-year-old Chinese woman was hit by a car in a road traffic accident. Local county hospital considered that her right knee was injured, but didn't find any sign of fracture from X-ray imaging. Then the hospital gave diagnosis of soft tissue contusion and the patient started to exercise with burden 21 days after her right lower limb was fixed by plaster slab. Four months later, she had to go back to the county hospital for recheck due to persistent pain on her right knee. Then, the right tibia outer plateau fracture was found. The patient rejected the advice of open reduction and internal fixation of right tibia plateau fracture. Instead, she accepted the unicompartmental knee arthroplasty in a hospital affiliated to a medical college. The patient felt the knee pain alleviated after surgery However, the joint dysfunction was aggravated even more. The patient used the legal procedure for personal compensation. Both driver and the insurance company disputed that the final consequence of the injured knee was due to not only the traffic accident, but also poor medical practice involved. Therefore the court consigned us to make judicial judgment of expertise. After investigation, we found the earliest X-ray graph after the accident had shown the fracture of right tibia outer plateau and right knee valgum, with articular surface involvement, and the traffic accident was considered as the primary cause of sequelae. At the same time, the county hospital missed the diagnosis of fracture, and led to insufficient fixation of right lower limb, which was not good for rehabilitation from fracture and joint injury. This was the secondary cause of sequelae. Additionally, instead of the standard therapy, the affiliated hospital of medical college made the unicompartmental knee arthroplasty four months later, which also had a little defect. It was the minor reason for the result.     

A degloving foot injury in a traffic accident

An unusual human remain found on a road became one key to reconstruct the traffic accident. A woman was found dead on a snow-covered road. Her left foot showed a large deficit of skin and underlying fat tissue. The detached skin and tissue were found into her left sock and shoe lying at a distance of 23 m from the body. There were multiple fractures on her back and occipital cranial bone. Severe injuries revealed in heart, liver, and brain. The neck remained intact. These findings suggested that her back has been strongly hit by the object with the flat surface, for example, the front side of a cab-over or truck, from behind at a high speed. Furthermore, the degloving injury in her left foot suggested that a vehicle ran over the foot which faced the vehicle. We reconstructed the accident as follows. Firstly the wheel of the vehicle ran over the victim's foot, and then, the victim turned away from the vehicle. Finally, the front side hit her twisted body from behind, resulting in a traumatic degloving injury.     

闭合性阴囊损伤的治疗与护理

回顾分析30例闭合性阴囊损伤患者临床治疗方法以及护理措施,均经非手术治疗后痊愈。围手术期护理是闭合性阴囊损伤患者能够顺利恢复的重要措施,对患者进行心理疏导,术后病情观察、疼痛护理等是关键因素。     

睾丸交通伤24例临床分析

目的：总结睾丸交通伤的诊治体会。方法：24例睾丸交通伤，年龄18－61岁。其中20例合并其他部位损伤；10例行阴囊B超检查；11例立即手术治疗，13例保守治疗。同时，与同期睾丸非交通伤30例进行对照分析。结果；手术治疗11例中，3例发现睾丸破裂行睾丸切除术，其余8例采用血肿清除术；保守治疗13例中，5例延期手术。睾丸交通伤的主要特点：（1）睾丸损伤程度重；（2）合并伤多；（3）容易漏误诊；（4）临床表现严重而复杂。结论：睾丸交通伤应早期手术，但当合并其他部位损伤时，应根据患者伤情程度及局部情况等决定。早期诊断，及时治疗是治愈本病的关键。     

兰州市2004年度道路交通事故伤流行病学分析

目的：探讨兰州市2004年度道路交通事故伤流行病学特征，为减少城市道路交通事故伤的发生提供科学依据。方法：收集2004年兰州市发生的交通事故资料，分析交通事故的流行病学特征。结果：伤亡人员年龄以21～40岁为多，男性为主；行人及骑自行车者为交通事故的最大受害者；机动车司机的过失是导致事故的最主要原因。结论：完善城市道路建设及规划；加强交通管理，严禁违规行车；加强道路交通法规和安全教育，提高驾乘人员和行人安全意识等是降低交通事故的主要措施。