腹部闭合性损伤合并肺挫裂伤的治疗  

Early Diagnosis and Treatment of Severe Pulmonary Contusion with Blunt Abdominal Injury

作　　者：刘现明[1] 赵宝勤[1] 张永伟[1] 

机构地区：[1]河南安阳钢铁集团有限责任公司职工总医院,安阳455004

出　　处：《河南外科学杂志》2011年第1期10-12,共3页Henan Journal of Surgery

摘　　要：目的探讨腹部闭合性损伤合并肺挫裂伤的治疗。方法回顾性分析我院收治28例严重腹部闭合性损伤合并肺挫裂伤病人的诊治临床资料。结果 28例中治愈26例,死亡2例。在治疗过程中并发ARDS 8例,肺炎11例,肺不张4例。结论严重腹部闭合性损伤合并肺挫裂伤较为常见,积极救治腹部闭合性损伤,重视肺挫裂伤的诊断与处理,胸部X线、CT检查是诊断的可靠依据。PaO2/F iO2是判断低氧血症严重程度的重要指标。保持呼吸道通畅、抗休克、积极治疗合并伤、控制晶体的输入量,适当加大胶体的输入,合理应用机械通气、激素和抗生素等是治疗严重肺挫伤的重要方法。Objective To explore the early diagnosis and treatment of blunt abdominal injury with severe pulmonary contusion.Methods 28 patients who suffered with blunt abdominal injury and severe pulmonary contusion were enrolled in this study.Their clinical data were analyzed to discuss the early diagnosis and treatment of these severe multitrauma.Results Twenty-eight cases survived and 2 cases died.During hospitalization,there were 8 cases complicated with ARDS,11 neumonia and 4 atelectasis.Conclusion Severe blunt abdominal trauma with pulmonary contusion are common multitrauma which need emergency treatment.Attention should be paid for the diagnosis and treatment of lung contusion during the active rescue of blunt abdominal injury.Chest X-ray and CT are reliable for the diagnosis of pulmonary contusion.PaO2/FiO2 ratio is important to judge the degree of hypoxemia.Airway patency,countershock treatment,crystal control,colloid infusion,mechanical ventilation,antibiotics and hormones are crucial for the treatment of severe pulmonary contusion.

关 键 词：腹部闭合性损伤 肺挫裂伤诊断 治疗 

分 类 号：R656[医药卫生—外科学]