腹部外伤术后近期再手术38例

目的探讨腹部外伤术后近期再手术的原因、预防及处理措施。方法回顾性分析1999年3月至2009年10月收治的38例腹部外伤术后近期因不同原因非计划性再手术病人的临床资料。结果再手术38例中,腹腔大出血9例,消化道瘘8例,胰瘘4例,胆漏3例,腹腔脓肿5例,肠梗阻4例,小肠坏死1例,切口裂开2例,阴性再手术1例,肝脓肿1例。再次手术后死亡4例(10.5%),余痊愈。结论术中探查仔细,操作精细,加强术后观察,提高首次手术质量,是提高腹部外伤疗效的关键;而合理掌握再手术指征、实施及时有效的再次手术可避免疾病进一步恶化。

Analysis of 38 cases of reoperation after abdominal trauma

Objective:To investigate the causes,prevention and treatment of unplanned reoperation after abdominal trauma.Methods:A retrospective analysis was done on the clinical data of 38 cases of unplanned reoperations after abdominal trauma from Mar.1999 to Oct.2009.Results:Among 38 cases of reoperations,abdominal bleeding occurred in 9 cases,gastrointestinal fistula in 8 cases,pancreatic fistula in 4 cases,bile leakage in 3 cases,intra-abdominal abscess in 5 cases,obstruction in 4 cases,intestinal necrosis in 1 ca...