胸腹联合伤32例诊治分析

目的:探讨胸腹联合伤的诊断及治疗特点.方法:总结经手术证实的胸腹联合伤32例,其中开放性损伤15例(46.87%),以锐器刺伤为主;闭合性损伤17例(53.13%),以交通伤多见.分析不同原因的损伤类别及不同临床症状与手术方式.结果:本组32例中存活30例,死亡2例,病死率6.25%,死亡原因:1例为ARDS,1例为肝静脉断裂出血.结论:胸腹联合伤是一种特殊类型的损伤,伤情复杂、严重,死亡率高.诊断应根据受伤机制和特点判断,特别注意避免漏诊膈肌损伤.治疗原则为"先全身后局部,先救命后治病;先处理胸部伤,后处理腹部伤".

Thoraco-abdominal combined injuries : Clinical analysis of 32 cases

Objective: To explore the diagnosis and treatment of thoraco-abdominal combined injuries(TCI).Methods : A retrospective study was carried out in 32 cases of TCI treated surgically,among which were 15 cases(46.87%)of open injury mainly caused by sharp instruments and 17(53.13 %) of closed injury commonly seen in traffic injury.The injuries due to different causes and their clinical signs as well as operative measures were analyzed.Results: Of 32 cases,30 surivived by surgical treatment,and two died due to neglect of the treatment of adult respiratory distress syndrome(ARDS) as well as bleeding of the ruptured hepatic vein.Conclusion: TCI is a special type of multiple trauma with its severity and complicated traumatic condition and a higher mortality.The diagnosis should be paid to the avoidance of the missed diagnosis of diaphragmatic muscle injuries.The treatment principle is thoracic injury first and laparotomy second.