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Abdominal Stab Wounds in Children: an 18-Year Experience 总被引:1,自引:0,他引:1
Hayrettin ?ztürk Abdurrahman Onen Selcuk Ot?u Ali hsan Dokucu Yusuf Yamur Senol Gedik 《European Journal of Trauma》2002,28(2):85-89
Objective: Evaluation of the diagnosis, management, and the role of selective treatment in children with abdominal stab wounds.
Patients and Methods: 59 children (56 male and three female) were included in the study. The patients' median age was 11.8 years (range, 5–14 years).
Time between injury and admission was about 3 h. Laparotomy was performed in 44 patients (74%). Solid organ injury was detected
in 32 of these patients (73%) and could not be observed in twelve (27%). 15 patients (26%) were treated conservatively, and
only one (6.6%) underwent laparotomy during the follow-up. The stomach was the most frequently injured organ (ten patients),
followed by the intestines (nine patients). Types of surgical treatment were as follows: primary suture in 28 patients, resection-anastomosis
in three, and osteotomy in two.
Results: Some prognostic factors such as presence of abdominal organ evisceration and pneumoperitoneum were not significantly correlated
with intraabdominal organ injury, whereas some other risk factors such as acute abdomen on admission (p < 0.002) or abdominal
clinical and hemodynamic findings (p < 0.001) showed significant correlation with intraabdominal organ injury. The relative
risk (odds ratio) of developing an intraabdominal organ injury was > 2 for patients with signs of an acute abdomen on admission.
Postoperative complications were observed in five patients with organ injuries. None of our patients died.
Conclusions: Conservative treatment can be safely performed in most children with abdominal stab injuries. Signs of major internal hemorrhage
or generalized peritonitis are an absolute indication for emergency operation for abdominal stab wounds. Peritoneal penetrations,
free air on the abdominal X-ray, and omental or intestinal evisceration are poor indicators of significant organ injuries,
and patients presenting these signs shold be closely followed up for developing acute abdominal symptoms.
Received: November 2, 2001; revision accepted: February 15, 2002 相似文献
85.
É. M. Kaz'mina I. I. Fedorov Ya. É. Bezchinskii N. V. Kiseleva N. A. Novikov G. G. Galegov A. P. Arzamastsev 《Pharmaceutical Chemistry Journal》1989,23(10):830-836
Translated from Khimiko-farmatsevticheskii Zhurnal, Vol. 23, No. 10, pp. 1217–1223, October, 1989. 相似文献
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准分子激光角膜屈光术后感染性角膜炎 总被引:1,自引:0,他引:1
准分子激光角膜屈光术后感染性角膜炎是准分子激光角膜屈光术后少见而严重的并发症,一旦发生,可对视力造成严重损害。完善的术前筛查及准备工作、术中严格的无菌操作、术后合理用药及定期随访、一旦感染发生能及时正确地处理可有效预防或控制感染,最大限度地减轻并发症对视力的损害。 相似文献
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Azra Raza Harvey D. Preisler Ya Qin Li Richard A. Larson Jack Goldberg George Browman John Bennett Hans Grunwald Ralph Vogler Cathi Kukla 《American journal of hematology》1993,42(4):359-366
A pilot study was conducted of the biological characteristics of the leukemia cells of newly diagnosed patients with poor prognosis acute myelogenous leukemia (AML). This study included measurements of the pretherapy proliferative rate of the leukemia cells in vivo, assessment of differentiation in vivo during remission induction therapy, and the level of expression of the fms, myc, and IL1β genes in pretherapy leukemia cells. Short cell cycle times were characteristic of the best prognostic category and were associated with a rapid reduction in marrow leukemia cells in cytosine arabinoside (araC)-sensitive patients. Expression of c-fms was associated with rapid reduction in marrow leukemia cells during araC therapy and with a successful treatment outcome. Expression of the IL1β gene was associated with short remissions. These studies suggest that when compared to newly diagnosed standard prognosis AML, the leukemia of poor prognosis patients is more likely to exhibit long cell cycle times, low levels of fms expression, and is less likely to be associated with myeloid differentiation during remission induction therapy. © 1993 Wiley-Liss, Inc. 相似文献
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