严重多发伤时腹损伤的诊断和剖腹时机探讨

收治１９８０年１月～１９９４年１２月的９２例腹部损伤伴严重多发伤病人，其严重程度根据ＡＩＳ＝ＩＳＳ（９０）评分法，ＩＳＳ值均＞１６。８８例手术病人治愈６７例（７６％），死亡２１例（２４％）。认为严重多发伤病人由于损伤的严重程度、部位和累及的脏器、深部组织的不同，伤情多较复杂，且变化快，休克发生率高，容易漏诊和误诊，在处理上存在着顺序上的矛盾。对如何能够早期诊断，正确把握手术时机，掌握合并伤的处理程序及剖腹手术时机和原则进行了讨论

DIAGNOSIS OF SEVERE MULTIPE ABDOMINAL INJURIES AND INGUIRY INTO LAPAROTOMY

patients with abdominal injury due to Serious multiple injuries were treated from January 1980 to Decemper 1994 at ZiBo Central Hospital.According to AIS-ISS(90),all patient's ISS>16.4 Cases died from nonoperation. In 88 operated cases, 67(76%)cases were cured; 21(24%)died.We thought that the patlent's manifestation were complicated, Because of different serious degrees, the location of an injury and different organs involved.and the depath of the tissues. Clinical development was fast and shock incidence was higher.It was easy to leave out a diagnosis of make a wronng diagnosis. In the treatment there was contradiction in sequence. It is discussed that how to diagnose early and seize operation time correctly.