摘要
目的:探讨胸腹联合伤的诊断及治疗特点。方法:总结经手术证实的胸腹联合伤26例,其中开放性损伤20例(76.92%),以锐器刺伤为主;闭合性损伤6例(23.07%),以交通肇事伤多见。分析不同原因的损伤类别及不同临床症状与手术方式。结果:26例中,术前明确有膈肌破裂12例(46.15%);1例在第一次手术中发现膈肌破裂,并予以修补25例(96.15%),未探查膈肌而漏诊1例(3.85%);死亡1例(3.85%)。结论:胸腹联合伤是一种特殊类型的损伤,伤情复杂、严重,死亡率高。诊断应根据受伤机制和出血量判断,特别注意避免漏诊膈肌损伤。治疗原则为先处理胸部损伤,后处理腹内脏器损伤。
Objective： To explore the characteristics of diagnosis and treatment of thoracoabdominal combined injuries （TCI）. Methods： A retrospective study was carried out for 26 cases of TCI treated surgically. 20 cases （76.92%） were of penetrating injury. 6 cases （23.07%） were of blunt injury caused by sharp instrument, mainly traffic injuries. The injuries due to different causes and their clinical signs as well as operative measures were analyzed. Results： of 26 cases, 12 （46.15%） had diaphrag matinieal ruptures preoperatively,25 （96.15%） diaphragmatic rupture was found in the first operation and was repaired; 1 （3.85%）did not receive diagnosis due to the neglecting of the diaphragm in operation ; and 1 （3.85%）died. Conclusions： TCI is a special type of multiple trauma with severe and complicated injuries and a high mortality. The diagnosis should be based on the mechanism of trauma and volume of bleeding. In the meantime,special attention should be paid to avoiding the missed diagnosis of diaphragmatic injuries. The treatment principle is thoracic injury first and laparotomy second.
出处
《大理学院学报（综合版）》
CAS
2009年第2期40-42,共3页
Journal of Dali University
关键词
胸部损伤
腹部损伤
膈肌
thoracicinjuries
abdominalinjuries
diaphragm
