闭合伤腹膜后血肿的诊断和处理  

Retroperitoneal Hematoma Following Blunt Abdominal Trauma.

作　　者：白涛[1] 姜法文[2] 许武楚 薛奎生 周继舜 

机构地区：[1]广州军区总医院 [2]解放军157医院 [3]解放军177医院 [4]解放军197医院

出　　处：《中华创伤杂志》1985年第2期87-89,共3页Chinese Journal of Trauma

摘　　要：本文报告闭合性腹部创伤所致腹膜后血肿44例,重点讨论血肿探查指征。本组根据血肿部位,邻近脏器,血管分布情况和血肿的形态决定是否探查。盆腔腹膜后血肿多与骨盆骨折有关,手术止血难以奏效,血肿探查应慎重。Forty-four patients of retroperitoneal hematoma（RH） following blunt abdominal trauma are studied. All were treated surgically with an overall mortality rate of 13.6^（6/44）. Among the 23 cases in whom retroperitoneal hematomas were also explored, 13 were found positive and treated accordingly, with a mortality rate of 18.1%（3/23）. This paper emphatically points out that whether the RH is explored during operation should be judged according to the location and characteristics of the hematoma,the nature of the adjacent organs, and the distribution of the adjacent vessels. Pelvic RH following blunt trauma is utmost uniformly due to fracture of pelvis where hemostasis is very difficult if not impossible, thus, exploration of this type of RH should he very cautious. Perirenal hematoma should be explored if found expanding or pulsatile denoting serious laceration of kidney or renal pedicle, whereas if RH is found small, nonexpanding or nenpulsatile, it may be left undisturbed. Other types of RH found close to retroperitoneal viscera, no matter how small they might be, should leadto the suspicion of injury of retroperitoneal viscera, exploration of such RH during operation is then absolutely necessary.

关 键 词：闭合伤 腹膜后血肿 骨盆骨折 手术治疗 血肿形态 

分 类 号：R656.4[医药卫生—外科学]