严重腹部多发伤的早期救治

目的探讨严重腹部多发伤的救治方法。方法对我院近3年来178例以腹部创伤为主的严重多发伤患者的流行病学特点、诊断、治疗及预后做回顾分析。结果178例全部经手术治疗。死亡15例（8．4％）。其中因失血过多．术后35h内死亡10例；术后2周以上死于MODS5例。以腹内出血为主的失血性休克存活组与死亡组之间．其内脏损伤个数、腹内出血量、休克程度和休克持续时间的比较差异均有统计学意义（P〈0．01）。结论尽早行确定性手术治疗。快速有效的止血。避免涌诊是降低病死率的主要措施。

EARLY EMERGENCY AID AND THERAPY OF SEVERE MULTIPLE ABDOMINAL INJURIES

Objective To investigate emergency aid and therapy for severe multiple abdominal injuries. Methods The epidemiological characteristics, diagnosis, therapy and outcome of 178 cases with severe multiple abdominal injuries as chief trauma were analyzed retrospectively. Results All of the 178 patients studied were operated with 15 cases death (8.4%), 10 of which died of massive bleeding within 35 h and the other 5 died of MODS in 2 weeks after their operations. In hemorrhagic shock mainly caused by intra-abdominal bleeding, there were significant difference in number of injured viscera, amount of abdomen bleeding, severity of shock and duration of shock between the survival group and the death group (P<0.01). Conclusion Early decisive operation, quick and effective arrest of hemorrhage and avoidance of miss diagnosis are the key measures for decrease the mortality.