穿透性胸腹联合伤的临床特点与救治  

Clinical features and early management of penetrating combined thoracoabdominal injury

作　　者：王飙[1] 郭佳[1] 王剑平[1] 陈志强[1] 吴增安[1] 田进涛 宋小平 

机构地区：[1]中国中医科学院望京医院外科,北京100102 [2]清华大学第一附属医院胸外科

出　　处：《中国医药》2010年第10期930-931,共2页China Medicine

摘　　要：目的总结穿透性胸腹联合伤临床特点与早期救治经验。方法回顾性分析1985年6月至2008年6月经手术证实的46例穿透性胸腹联合伤患者的诊断、治疗及疗效等临床资料。结果38例行剖胸手术，5例行剖腹手术，2例行剖胸＋剖腹手术，1例行胸腹联合切口。治愈44例；死亡2例，其中1例死于心包填塞，1例死于心脏破裂。结论穿透性胸腹联合伤患者应及早手术，对于伤口位于季肋部的应以开胸探查为主，便于肝、脾脏膈面裂伤修补，减少脾脏切除。Objective To summarize the clinical features and early management of penetrating combined thoracoabdominal injury. Methods Fourty-six cases of penetrating combined thoracoabdominal wounds approved by surgery from June 1985 to June 2008 were reviewed. Results Emergency thoracotomy was carried out in 38 cases, laparotomy in 5 cases, simultaneous thoracotomy and laparotomy in 2 cases, and thoracoabdominal incision in 1 case. There were 2 deaths of all the cases, 1 in pericardial tamponade and 1 in heart rupture. Conclusions Early surgery should be carried out. If the injury is at hypochondrium, thoracotomy may be appropriate in order to repair liver and spleen with injury in diaphragmatic surface, and to decrease resective rate of spleen.

关 键 词：胸腹联合伤 手术 诊断 

分 类 号：R641[医药卫生—外科学]