CAJ | 학술논문

目的总结以胸腹部联合伤为主的多发伤的早期诊断与急诊手术的经验. 方法对2001年7月-2009年8月收治的58例以胸腹联合伤为主的多发伤患者的临床资料进行回顾性分析. 结果患者入院后均行胸腔闭式引流术.开胸手术12例,剖腹手术36例,同时行胸部和腹部切口7例,经胸腹联合切口3例.其中行四肢长干骨内固定术27例,脊柱椎板减压椎弓根内固定术5例,截肢术1例.术后发生成人呼吸窘迫综合征6例,并发多器官功能不全综合征12例.治愈53例,死亡5例. 结论以胸腹联合伤为主的多发伤病情重,表现复杂.早期CT扫描对以胸腹联合伤为主的多发伤的早期诊断有重要作用.胸腔闭式引流是腹部手术安全进行的重要保证.早期诊断、正确选择手术方式和受损器官的处理顺序能提高抢救成功率.
목적 총결이흉복부연합상위주적다발상적조기진단여급진수술적경험. 방법 대2001년7월-2009년8월수치적58례이흉복연합상위주적다발상환자적림상자료진행회고성분석. 결과 환자입원후균행흉강폐식인류술.개흉수술12례,부복수술36례,동시행흉부화복부절구7례,경흉복연합절구3례.기중행사지장간골내고정술27례,척주추판감압추궁근내고정술5례,절지술1례.술후발생성인호흡군박종합정6례,병발다기관공능불전종합정12례.치유53례,사망5례. 결론 이흉복연합상위주적다발상병정중,표현복잡.조기CT소묘대이흉복연합상위주적다발상적조기진단유중요작용.흉강폐식인류시복부수술안전진행적중요보증.조기진단、정학선택수술방식화수손기관적처리순서능제고창구성공솔.
Objective To summarize the experience in early diagnosis and emergency treatment for combined thoracoabdominal injury (CTI). Methods Clinical data of 58 cases of CTI admitted to our hospital from June 2001 to August 2009 were analyzed retrospectively.All the patients were treated by closed drainage of thoracic cavity,of which 12 cases were treated with thoracotomy,31 with laparotomy,seven with thoracic and abdominal incisions and three with combined thoracoabdominal incision.Internal fixation for long limb bones was performed in 27 cases,spinal laminectomy and pedicle screw fixation in five and amputation in one. Results After operation,six cases were found to have adult respiratory distress syndrome (ARDS) and 12 cases were complicated with multiple organ dysfunction syndrome (MODS).Fifty-three cases were cured and five died. Conclusions CTI based multiple injuries are severe and complicated.CT scan in the early stage plays a significant role in the diagnosis of CTI and closed drainage of thoracic cavity is an important assurance of the security of abdominal operation.Early diagnosis,correct choice of operation procedures and reasonable handling order of injured organs can improve the successful rescue rate for multiple injury patients.