外伤性小肠破裂的诊治  

Diagnosis and treatment of traumatic rupture of small intestine

作　　者：郑海[1] 陈明[1] 陈庆永[1] 方开锋[1] 张进祥[1] 彭万勇[1] 蒋春舫[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院普外科,武汉430022

出　　处：《腹部外科》2009年第1期20-22,共3页Journal of Abdominal Surgery

摘　　要：目的探讨外伤性小肠破裂的早期诊断及治疗方法。方法对288例外伤性小肠破裂病人的临床资料进行回顾性分析。结果典型腹膜炎表现者209例(72.6%);腹腔穿刺198例,阳性175例(88.4%);腹腔灌洗28例,阳性22例(78.6%);B型超声检查214例,阳性177例(82.7%);288例KUB平片,发现膈下游离气体143例(49.7%);CT检查65例,阳性43例(66.2%)。治愈280例(97.2%),死亡8例。结论重视外伤性小肠破裂常见症状和体征,积极应用各种腹腔穿刺技术,并结合血常规、X线、B型超声、CT等辅助检查,早期诊断,避免漏诊误诊,尽早手术探查,选择合理术式可明显提高治愈率及病人生活质量。Objective To explore the early diagnosis and treatment of traumatic rupture of small intestine. Methods The clinical data of 288 cases of traumatic rupture of small intestine were analyzed retrospectively. Results There were 209 cases presenting typical symptoms and signs of peritonitis （72. 6 %）. There were 175 positive cases among 198 cases undergoing diagnostic abdominal puncture, accounting for 88. 4 %. There were 22 positive cases among 28 cases undergoing peritoneal lavage,aecounting for 78. 6 %. There were 177 positive cases among 214 cases subject to B-ultrasonography （82. 7 %）. 143 cases had free air below diaphragm on the KUB X-ray films among 288 cases （49. 7 %）. And there were 43 positive cases among 65 cases undergoing CT scan（66. 2 %）. 280 cases （97. 2 %）were cured clinically, and there were 8 deaths. Conclusion To be familiar with the clinical symptoms and signs related to the traumatic rupture of small intestine, using the techniques of diagnostic abdominal puncture combined with assistant examinations such as blood-test, X ray, Prultrasonography, or CT, and making correct diagnosis and operating as soon as possible can increase the curate rate significantly.

关 键 词：腹部损伤 小肠 剖腹术 诊断 

分 类 号：R656.7[医药卫生—外科学] R169.42[医药卫生—临床医学]