281例腹部火器伤的诊治

目的 研究战时腹部火器伤的诊治。方法 回顾分析我院１９７９～１９８９年收治的２８１例腹部火器伤。结果 早期诊断符合率９６．８％（２７２／２８１），一线医院误诊率３．２％（９／２８１）。严重并发症有：胃肠瘘２３例（８．２％），腹腔脓肿３４例（１２．１％），切口感染３２例（１１．４％），感染性休克２６例（９．３％），弥漫性血管内凝血（ＤＩＣ）１４例（５．０％），成人呼吸窘迫综合征（ＡＲＤＳ）８例（２．

Diagnosis and treatment of abdominal firearm injury under field environment in 281 cases

Objective To study the diagnosis and treatment of abdominal injury during wartime. Methods A total of 281 cases of abdominal firearm injury from 1979 to 1989 were retrospectively studied in the hospital. Results The conformity percentage of early diagnosis was 96.8%, and the misdiagnosis rate was 3.2%. The main complications included gastrointestinal fistula in 23 cases (8.2%), intra abdominal abscess in 34 cases (12.1%), wound infection in 32 cases (11.4%), sepsis shock in 26 cases (9.3%), disseminated intravascular coagulation (DIC) in 14 cases (5.0%), adult respiratory distress syndrome (ARDS) in 8 cases (2.8%), mechanical intestinal obstruction in 6 cases (2.1%), acute renal failure in 4 cases (1.4%) , and emphysematous gangrene in 1 case (0.4%). Conclusions The main factors causing misdiagnosis are the ignorance of the wound history and careless examination of abdomen in the forepart diagnosis. And improper treatment at the early stage is the important factor of anaphase high complication rate.