37例妊娠期腹部闭合性损伤的临床分析  

Clinical analysis on 37 cases with occlusive abdominal injuries during pregnancy

作　　者：王绍娟[1] 周日光[2] 韦杨义[3] 

机构地区：[1]深圳市龙岗中心医院妇产科,518116 [2]深圳市龙岗中心医院普通外科,518116 [3]湖南中医学院第一附属医院普通外科

出　　处：《中华创伤杂志》2004年第8期488-490,共3页Chinese Journal of Trauma

摘　　要：目的　探讨妊娠期腹部闭合性损伤的特点及救治方法。　方法　总结 1993年 6月～ 2 0 0 3年 6月收治的 37例妊娠期腹部闭合性损伤的临床资料。　结果　 37例均进行手术治疗 ,其中早孕合并肠破裂 2例、腹膜后血肿 1例在腹腔镜下直接处理 ;其余 34例均行开腹手术 ,其中 8例因胎盘早剥和 (或 )增大的子宫阻碍腹内脏器损伤的处理而行剖宫取胎术。 37例中治愈 33例 (89% ) ,死亡 4例 (11% )。术后并发症发生率 16 % (6 /37) ,其中腹腔感染 2例 (5 % ) ,肺部感染 3例 (8% ) ,多器官功能衰竭 1例 (3% )。　结论　妊娠期腹部闭合性损伤除考虑产科疾病外应高度警惕腹腔脏器的损伤。妊娠期腹部闭合性损伤准确诊断和及时处理 ,将给母婴的抢救赢得时间。Objective To study the characteristics and treatments of occlusive abdominal injuries during pregnancy. Methods The clinical data of 37 cases with occlusive abdominal injuries admitted in hospital from June 1993 to June 2003 were collected for study. Results All 37 cases received operative treatment, of which two cases complicated by enterorrhexis in the early pregnancy and one by retroperitoneal hematoma were managed using laparoscope. Laparotomy was performed in other 34 cases, of which eight received caesaren section because of placental abruption and enlarged uterus that impeded the management for intraabdominal organs. Of all, 33 cases (33/37,89%) were cured and four (4/37, 11%) died. The postoperative incidence of complications was 16% (6/37). The complications included abdominal cavity infection in two cases (5%), pulmonary infection in three (8%) and multiple organ failure in one (3%). Conclusion Besides obstetrics' diseases, we must keep alert about the injury of abdominal organs during the management of trauma. Accurate diagnosis and timely treatment will win time to save the lives of mother and infant.

关 键 词：妊娠期 腹部损伤 闭合性损伤 腹腔镜检查 外科手术 并发症 

分 类 号：R714.25[医药卫生—妇产科学]