骨盆骨折合并直肠肛管损伤的救治

作者收集两院1976～1995年治疗180例骨盆骨折病例,对其20例合并直肠肛管损伤提出早期诊断方法,强调在积极抗休克的基础上手术探查止血和早期处理直肠肛管损伤,并应用药物溶液灌洗盆腔和骶前引流,以防治感染.对刺破肠管的骨折片采取复位并羊肠线捆扎固定.腹膜后血肿若逐渐增大,血压继续下降则结扎髂内动脉止血,未见不良影响.

Diagnosis and Treatment about the Trauma of the Rectum and Canalis Analis after Pelvic Frcatures

From 1976 to 1995, 180 cases of pelvic fractures were treated in Jiangxi province people's Hospital and 92 PLA Hospital. There were 20 cases that accompanied by trauma of rectum and canalis analis among these patients. The authors suggested early diagnosis method in these patients. The authors emphasized hemostasis by operative exploration and early treatment of the trauma of rectum and canalis analis after positive anti -shock treatment, and then using drug preperation of irrigate pelvic cavities and draining through presacral space for prevention of infection. The fragment of bone that sticked into intestine could be replaced and fixed by ligation with catgut. If the retroperitoned hemotoma enlarged gradually and blood pressure dropped continuosly, the iliaca interna could be ligated for hemostasis without adverse effect.