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出 处:《中华创伤杂志》2000年第6期373-375,共3页Chinese Journal of Trauma
摘 要:目的 研究战时腹部火器伤的诊治。 方法 回顾分析我院 1979~ 1989年收治的2 81例腹部火器伤。 结果 早期诊断符合率 96 .8% (2 72 2 81) ,一线医院误诊率 3.2 % (9 2 81)。严重并发症有 :胃肠瘘 2 3例 (8.2 % ) ,腹腔脓肿 34例 (12 .1% ) ,切口感染 32例 (11.4% ) ,感染性休克 2 6例 (9.3% ) ,弥漫性血管内凝血 (DIC) 14例 (5 .0 % ) ,成人呼吸窘迫综合征 (ARDS) 8例(2 .8% ) ,机械性肠梗阻 6例 (2 .1% ) ,急性肾功能衰竭 4例 (1.4% ) ,气性坏疽 1例 (0 .4% )。治愈2 6 8例 (95 .4% ) ,死亡 13例 (4.6 % )。 结论 早期诊断忽视负伤史和腹部检查不仔细是误诊的主要原因 ,早期诊治不当是后期高并发症的重要因素。Objective To study the diagnosis and treatment of abdominal injury during wartime. Methods A total of 281 cases of abdominal firearm injury from 1979 to 1989 were retrospectively studied in the hospital. Results The conformity percentage of early diagnosis was 96.8%, and the misdiagnosis rate was 3.2%. The main complications included gastrointestinal fistula in 23 cases (8.2%), intra abdominal abscess in 34 cases (12.1%), wound infection in 32 cases (11.4%), sepsis shock in 26 cases (9.3%), disseminated intravascular coagulation (DIC) in 14 cases (5.0%), adult respiratory distress syndrome (ARDS) in 8 cases (2.8%), mechanical intestinal obstruction in 6 cases (2.1%), acute renal failure in 4 cases (1.4%) , and emphysematous gangrene in 1 case (0.4%). Conclusions The main factors causing misdiagnosis are the ignorance of the wound history and careless examination of abdomen in the forepart diagnosis. And improper treatment at the early stage is the important factor of anaphase high complication rate.
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