骨盆骨折合并直肠肛管损伤的诊治

目的探讨提高骨盆骨折合并直肠肛管损伤的救治水平。方法回顾性总结１９６６～１９９６年骨盆骨折合并直肠肛管损伤１６例，采用转流性结肠造瘘与骶前引流；对合并大出血休克的病人８例在抗休克治疗的同时，早期开腹手术，结扎髂内动脉，填塞止血。结果本组治愈１３例；死亡３例，其中死于多器官衰竭（ＭＳＯＦ）２例，死于败血症１例。结论正确的早期诊断和有效的早期治疗是提高骨盆骨折合并直肠肛管损伤疗效的关键

Diagnosis and therapy of pelvic fracture with colorectal injury

Objective To evaluate the effect of surgical treatment on pelvic fracture complicated by colorectal injury.Methods We summarized 16 cases of pelvic fracture complicated by colorectal injury from 1966 to 1996. Most patients were treated by colostomy and antesacral drainage. For 8 cases accompanied with hemorrhagic shock,early laparotomy without any hesitation after short aggressive resuscitation was performed,and the internal iliac artery was ligated and the packing bemostasis adopted.Results The cure rate was 81 2% (13/16), The mortality was 18 8% (3/16) with 2 patients dying from multiple system organ failure,and one from septicemia.Conclusions The key to the therapy of pelvic fracture with colorectal injury is early diagnosis and effective treatment.