自发性腹腔出血的诊治探讨  

Study on diagnosis and treatment of spontaneous intraperitoneal hemorrhage

作　　者：刘文斌[1] 刘西飞[1] 刘树辉[1] 

机构地区：[1]大英县人民医院,四川大英629300

出　　处：《现代医药卫生》2012年第10期1490-1491,共2页Journal of Modern Medicine & Health

摘　　要：目的探讨自发性腹腔出血的病因及诊治方法。方法回顾分析21例自发性腹腔出血患者的相关病史、发病诱因及临床拟诊,并与手术发现相对照,观察缝扎止血与单纯腹腔引流的治疗效果。结果 21例患者均行诊断性腹腔穿刺,15例抽出不凝血。21例患者均行手术治疗。其中有明显出血灶的14例中,采用缝扎止血10例,缝扎止血合并切除病灶组织4例,疗效良好;余7例仅见血肿,行腹腔置管引流。21例患者中19例治愈,2例死亡。结论自发性腹腔出血多为各种病因所致腹腔血管结构变异畸形或小血管瘤形成,当腹腔压力升高时引起血管破裂出血。掌握相关病史和发病诱因,通过诊断性腹腔穿刺获得阳性结果有助于该病的诊断。早期手术探查、确切的止血措施能提高治愈率。Objective To study the etiology and treatment methods in spontaneous intrapetitoneal hemorrhage.Methods To retrospectively analyze the relative medical history and predisposing factors,and to compare the clinical suspected diagnosis with operative findings in 21 cases of spontaneous intrapetitoneal hemorrhage.Meanwhile the curative effects of suture-ligation for stopping bleeding and simple intraperitoneal drainage were observed.Results 21 cases were performed diagnostic abdominocentesis.Unclotted blood was extracted in 15 cases.All 21 cases adopted the operation treatment.Among 14 cases of obvious bleeding focus,10 cases were performed suture-ligation for stopping bleeding,and 4 cases adopted suture-ligation combined with lesion tissues resection with good curative effects.Other 7 cases were found hematoma and treated by placing the abdominal tube for drainage.Among 21 cases,19 cases were cured and 2 cases died.Conclusion Spontaneous intraperitoneal hemorrhage is mainly caused by angiorrhexis and bleeding due to increased abdominal pressure in the structure variation and deformity of the adbominal blood vessels or small hemangioma formed by various etiologies.Mastering the relative medical history and the predisposing factors,and the positive results obtained by diagnostic abdominocentesis are conducive to diagnose this disease.Early operative exploration and exact stopping bleeding measures can increase the cure rate.

关 键 词：腹腔积血/病因学 缝合技术 止血技术 腹腔 引流术 

分 类 号：R656.1[医药卫生—急诊医学]