34例闭合性腹部创伤急诊治疗分析  

Analysis of Emergency Treatment of 34 Cases of Closed Abdominal Trauma

作　　者：韦世壮[1] 李振华[1] 杜海华 黄承宇 石才汇 WEI Shizhuang;LI Zhenhua;DU Haihua;HUANG Chengyu;SHI Caihui(Nanning First People's Hospital,Nanning,Guangxi 530000,China)

机构地区：[1]南宁市第一人民医院,广西南宁530000

出　　处：《大医生》2020年第17期47-49,共3页Doctor

摘　　要：目的对34例闭合性腹部创伤病人的急诊治疗进行分析。方法选取2017年1月至2020年7月南宁市第一人民医院收治的闭合性腹部创伤病人34例,对其临床特征、影像学检查和急诊治疗方式、临床转归进行分析。结果本研究中34例腹部创伤患者,急诊科抢救无效死亡2例,1例为多发性内脏破裂合并重度颅脑损伤,1例为多发性内脏破裂、骨盆骨折合并失血性休克;32例腹部损伤患者行急诊剖腹探查术,其中脾脏损伤(破裂)行脾切除12例,肝脏破裂或挫裂伤行肝切除(右或左叶)7例;肠道损伤肠切除6例,肠系膜血管损伤缝合止血2例,盆腔血肿行填塞止血及髂内动脉结扎5例。34例腹部创伤患者,经急诊抢救无效2例,经救治后痊愈32例,死亡率为5.88%。结论闭合性腹部创伤强调急诊紧急补液、复苏抗休克治疗,抽血化验、配血,快速完善检查(腹部彩色多普勒超声检查或腹部CT检查等)评估腹部情况,快速送手术治疗,急诊等待时间越短,手术越早效果越好。Objective To observe and analyze the emergency treatment of 34 cases of closed abdominal trauma.Methods Totally 34 patients with closed abdominal trauma admitted to Nanning First People's Hospital from January 2017 to July 2020 were selected,and their clinical features,imaging examination,emergency treatment methods and clinical outcomes were analyzed.Results Among the 34 patients with abdominal trauma in this study,2 died after emergency treatment,1 was multiple visceral rupture with severe craniocerebral injury,and 1 was multiple visceral rupture and pelvic fracture with hemorrhagic shock.32 patients with abdominal injury underwent laparotomy in emergency operation,including 12 cases of spleen injury(rupture)and 7 cases of liver rupture or contusion(right or left lobe);Intestinal injury was resected in 6 cases,mesenteric vascular injury was sutured for hemostasis in 2 cases,pelvic hematoma was tamponaded for hemostasis and internal iliac artery ligation in 5 cases.Of the 34 patients with abdominal trauma,2 were ineffective after emergency treatment,and 32 were cured after treatment,with a mortality rate of 5.88%.Conclusion Closed abdominal trauma emphasizes emergency rehydration,resuscitation and anti-shock treatment,blood test,blood matching,quick and perfect examination(abdominal color doppler ultrasound or abdominal CT examination,etc.)to evaluate the abdominal condition,and send it to surgery quickly.The shorter the waiting time in emergency department,the sooner the operation,the better the effect.

关 键 词：临床救治 急诊治疗 闭合性腹部创伤 腹部探查 

分 类 号：R47[医药卫生—护理学]