95例腹部闭合性创伤合并颅脑损伤的诊断与治疗  

An analysis on the diagnosis and treatment of 102 cases with closed abdominal injury associated cerebral trauma

作　　者：郑可夫[1] 林关朋 张萍[1] 

机构地区：[1]广东省梅州市蕉岭县人民医院普通外科,广东蕉岭514100

出　　处：《海南医学》2005年第6期30-32,共3页Hainan Medical Journal

摘　　要：目的总结腹部闭合性损伤合并颅脑损伤诊断和治疗经验,以期提高外科危急重症的抢救成功率。方法回顾性分析1996～2004年收治的腹部闭合性损伤合并颅脑损伤102例患者。结果85例行急诊手术抢救,17例非手术保守治疗;85例手术患者中,75例急诊行剖腹探查术,急诊行颅脑手术者68例,腹脑同时手术者45例;剖腹探查阳性率93.3%(70/75),68例开颅患者术前均CT检查确诊;85例手术者死亡16例,病死率18.8%,17例非手术者中8例死于创伤后6小时内,死亡率47.1%。结论诊治腹部创伤的同时,应重视颅脑外伤的早期诊断,并应根据伤情的主次选择手术主次,条件允许者可同时开腹开颅;准确判断病情,有手术指征者,应尽快进行手术,避免失去手术抢救机会。Objective To summarize the experience of patients with abdominal injury associated cerebral trauma in order to improve the rescuing achievement radio of surgical severe cases. Methods 102 patientn with severe closed abdominal injury associated cerebral trauma hospitalized in 1996～2004 years were analyzed retrospectively. Results 85 cases were performed emergency operation and 17 cases got expectant treatment. Among them 75 cases were performed abdominal exploration operation 68 cases were performed cerebral operation and 45 cases were operated on abdomen and encephalon simultaneously. The positive radio of exploratory is 93.3% 70/75 when abdomen opened. 68 cases who got skull open were diagnosed with CT check. The case fatality rate of operation is 18.8% but the death rate of expectant treatment is 47.1%. Conclusions To deal with the patients with cerebral trauma special attention must be paid to the early diagnosis of associated abdomen injury simultaneously. It is important to arrange operating procedure according to what is prime or next important condition. It is appropriate to arrange operation on abdomen and encephalon simultaneously. In order not to lose operating opportunity the most vital factor is to judge the state accurately.

关 键 词：腹部损伤 颅脑损伤 诊断 治疗 

分 类 号：R656[医药卫生—外科学]