腹部开放性刀刺伤剖腹探查与保守治疗探讨

目的　探讨腹部开放性刀刺伤剖腹探查与保守治疗的经验。方法　回顾性分析近期 116例腹部开放性刀刺伤的诊治经过。结果　本组共 116例 ,剖腹探查 88例 ,保守治疗 2 8例 ,其中 2例转剖腹手术。在 88例行剖腹探查手术中 ,15例仅发现有网膜血肿、肠壁浆膜层裂伤、肝脾表浅刺伤。亦即是可以非手术治疗治愈的病例。死亡2例 ,均为失血性休克、全身多发刀刺伤病人 ,手术后抢救无效死亡 ,其余病例均治愈出院。结论　部分腹部开放性刀刺伤病例可在严密的监测下通过保守治疗治愈 ,但必须结合患者症状、生命征、腹部体征、腹穿以及B超CT的检查结果综合分析 ,严格掌握适应症。

Study of operative or presevative treatment for patients with open abdominal stab wound

Objective To study expirence of operation and presevative treatment for open abdominal stab wound.Methods 116 patients with open abdominal stab wound underwent operative or presevative treatment were retrospectively analyzed.Results 88 caces were treated by exploratory laparotomy; 28 caces were treated by presevative method, among the presevative group, 2 caces were transferred to operation;two caces died of hemorrhagic shock and multiple injury.Conclusions Some patients with open abdominal stab wound can be cured by presevative method, but the indication should be strictly controlled.