闭合性腹部损伤的诊断和治疗策略  

The diagnosis and strategies of blunt abdominal injury

作　　者：王金宝[1] 肖承佐[1] 郝俊[1] 

机构地区：[1]广州医学院附属深圳沙井医院,广东深圳518104

出　　处：《临床和实验医学杂志》2010年第11期827-828,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨闭合性腹部损伤的诊断和治疗策略。方法对我院90例闭合性腹部损伤患者的早期诊断和策略进行归纳总结。结果 90例患者均行腹腔穿刺,其中阳性77例(85.6%),42例行B超检查,阳性36例(85.7%),B超诊断模糊或未行B超检查者行CT检查14例,阳性12例(85.7%)。本组患者手术治疗80例,术后并发膈下血肿11例,胸腔积液5例,胆瘘4例,肝周或创面感染3例,再出血1例,均对症治愈;保守治疗10例。治愈86例,死亡4例。结论对于闭合性腹部损伤患者应尽早诊断,客观、全面分析伤情,严密、细致观察病情变化,及时合理救治,切忌过分依赖特殊检查结果 ,或存在等待的侥幸心理等,以免延误诊断,丧失最佳手术时机。Objective Discuss the diagnosis and strategies of blunt abdominal injury.Methods Summarized 90 patients blunt abdominal injury patients with early diagnosis and strategies in our hospital.Results 90 patients were used abdominal paracentesis,positive were 77 cases（85.6%）,42 patients were used B-mode ultrasound,positive were 36 cases（85.7%）,14 cases patients B-mode ultrasound diagnosis ambiguous or did not use B-ultrasound ambiguous were used CT to examine,positive were 12 cases（85.7%）,surgical treatment 80 cases,postoperative subphrenic hematoma in 11 cases,pleural effusion in 5 cases,4 cases of biliary fistula,liver weeks or 3 cases of wound infection,1 case of recurrent bleeding,were symptomatic cure;conservative treatment 10 cases.86 cases Cured and 4 cases death.Conclusion Blunt abdominal injury patients should be diagnosed as early as possible,objective,comprehensive analysis the injury,strict,careful observe the condition changes,timely and reasonable treatment and avoid over-reliance on the special inspection results,can not exist to wait for the chances so as to avoid delay in diagnosis,lose optimal timing of surgery.

关 键 词：闭合性 腹部损伤 诊断 治疗 

分 类 号：R656[医药卫生—外科学]