胸腹联合伤40例治疗分析

目的探讨胸腹联合伤的治疗。方法回顾性分析40例胸腹联合伤的治疗情况：剖胸加剖腹手术15例，开胸手术处理胸内损伤后经膈肌裂口扩大行腹腔脏器修补9例，剖腹手术加胸腔闭式引流16例。结果治愈37例，并发脓胸2例，肺部感染4例，胰瘘1例。ARDS1例。死亡3例，病死率7．5％，其中2例均死于失血性休克，1例死于多器官功能衰竭。结论胸腹联合伤伤情复杂、严重，诊断应根据受伤机制和出血量判断，治疗原则为优先处理危及生命的器官伤。

Diagnosis and treatment of thorax and abdomen trauma

Objective To study the diagnosis and treatment of thorax and abdomen trauma.Methods 40 cases with thorax and abdomen trauma were analyzed retro spectively:exploratory thoracotomy and laparotomy(15 cases),9 patients were managed by thoracotomy with enterocoelia organ repair through diaphragm,16 cases were performed by thoracotomy thoracic cavity closed drainage.Results 37 cases were cured,2 patients complicated with empyema,4 patients had pulmonary infection,1 case had pancreatic fistula,1 case was ARDS,3 patients were dead.Conclusion Patients with thorax and abdomen trauma should be over-all assessed according to injury mechanism,blood loss,and Physical sign.Principle of treatment is to deal with the important organ injury first.