腹部枪弹伤治疗原则  

Principles and research progress of abdominal gunshot wounds

作　　者：李一丁 王晓谦 洪流 LI Yi-ding;WANG Xiao-qian;HONG Liu(Department of Gastroenterology,First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院消化病医院,西安710032

出　　处：《创伤外科杂志》2020年第8期638-640,F0003,共4页Journal of Traumatic Surgery

摘　　要：腹部穿透伤的治疗方法在不断发展。20世纪上半叶,腹部穿透伤患者均行常规剖腹手术。然而,专家们很快就意识到并非所有穿透性腹部损伤都需要手术,因此选择性非手术治疗(SNOM)开始用于腹部刺伤。但考虑到枪弹伤(GSWs)中内脏和腹部血管损伤发生率较高,以及因漏检导致病死率较高,仍建议强制性剖腹手术治疗。但是,越来越多专家研究发现SNOM用于GSWs可以成功,同时减少了发病率和住院时间。本文概述SNOM腹部GSWs的争议及不同部位腹部GSWs的治疗原则,以期为SNOM用于腹部GSWs治疗提供依据。The treatment of abdominal penetrating wounds is constantly evolving. In the first half of the 20 th century,all patients with abdominal penetrating injuries underwent routine laparotomy. However,experts quickly realized that not all penetrating abdominal injuries require surgery,so selective nonoperative management( SNOM) began to be used for abdominal stab wounds. But experts have considered forced laparotomy for the high incidence of visceral and abdominal vascular injuries in gunshot wounds( GSWs) and the high mortality due to missed detection.However,more and more experts have found that SNOM can be used successfully for GSWs,while reducing morbidity and hospital stay. This article will focus on the controversy of SNOM abdominal GSWs and the treatment principles of abdominal GSWs in different parts,in order to provide a basis for SNOM for the treatment of abdominal GSWs.

关 键 词：腹部枪弹伤 腹部穿透伤 选择性非手术治疗 指征 

分 类 号：R826.65[医药卫生—临床医学]