穿透性胸腹联合伤57例临床研究  

Penetrating thoracoabdominil combined injury:a report of 57 cases

作　　者：李新平[1] 廖庆武[2] 邹建华[3] Dubaba Hassan 

机构地区：[1]同济大学附属同济医院普外科,上海200065 [2]上海复旦大学附属中山医院SICU,上海200032 [3]上海交通大学附属第六人民医院普外科,上海200233 [4]赛达特省哈桑二世医院外科,摩洛哥999055

出　　处：《同济大学学报（医学版）》2013年第6期114-117,共4页Journal of Tongji University(Medical Science)

摘　　要：目的总结穿透性胸腹部联合伤的早期诊断与急诊手术经验。方法对2009年10月—2012年10月摩洛哥赛达特哈桑二世医院收治的57例穿透性胸腹联合伤患者的临床资料进行回顾性分析。结果患者入院后均行剖腹探查手术,其中52例术前胸腔闭式引流,5例术中/后胸腔闭式引流,延迟开胸手术7例,再次剖腹手术1例。术后并发多器官功能不全综合征15例。治愈51例,死亡6例。结论术前预判对穿透性胸腹联合伤早期诊断非常重要,经腹入路可有效治疗大多数此类患者,胸腔闭式引流是腹部手术安全进行的重要保证,也是评判是否需要开胸手术的重要依据。Objective To review the early diagnosis and emergency treatment for penetrating thoracoabdominal combined injury （TCI）. Methods Clinical data of 57 cases of penetrating TCI admitted to Hassan I~ Hospital, Morocco from October 2009 to October 2012 were analyzed retrospectively. Results All the patients were treated with laparotomy, among whom 52 received closed drainage of thoracic cavity before operation and 5 during and after operation. Seven cases were treated with delayed thoracotomy and one with relaparotomy. Fifteen cases were complicated with multiple organ dysfunction syndrome （MODS） after operation, 51 cases were cured and 6 died. Conclusion Preoperative investigation is crucial for diagnosis in early stage of penetrating TCI. Majority of the patients can be cured by laparotomy ; closed drainage of thoracic cavity is important for success of abdominal operation and also provides a basis for decision-making of thoracotomy.

关 键 词：胸腹联合伤 膈肌 诊治 

分 类 号：R641[医药卫生—外科学]