中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2011年
4期
473-475
,共3页
创伤%腹膜后血肿%探查%临床研究
創傷%腹膜後血腫%探查%臨床研究
창상%복막후혈종%탐사%림상연구
Trauma%Retroperitoneal hematoma%Exploration%Clinical research
目的 探讨创伤性腹膜后血肿(TRH)的诊断、治疗方法及预后情况.方法 回顾性分析75例创伤性腹膜后血肿患者的完整临床资料.结果 62例手术患者中死亡5例,占手术患者的8.1%,57例全部治愈.其中1例因刀刺伤导致脾血管断裂、腹主动脉损伤,于术中死于失血性休克,累计失血量达5 000 ml;1例伴有重度颅脑损伤,死于脑疝.另3例死于术后多器官功能衰竭.13例保守治疗者治愈出院.总体治愈70例,治愈率达93.3%.结论 在多发性创伤时应特别注意是否存在创伤性腹膜后血肿,病情允许时可行CT检查明确腹膜后血肿的存在及有无腹腔脏器损伤,准确掌握创伤性腹膜后血肿的治疗原则,严格把握手术指征及腹膜后血肿探查的适应证,以挽救生命,减低病死率.
目的 探討創傷性腹膜後血腫(TRH)的診斷、治療方法及預後情況.方法 迴顧性分析75例創傷性腹膜後血腫患者的完整臨床資料.結果 62例手術患者中死亡5例,佔手術患者的8.1%,57例全部治愈.其中1例因刀刺傷導緻脾血管斷裂、腹主動脈損傷,于術中死于失血性休剋,纍計失血量達5 000 ml;1例伴有重度顱腦損傷,死于腦疝.另3例死于術後多器官功能衰竭.13例保守治療者治愈齣院.總體治愈70例,治愈率達93.3%.結論 在多髮性創傷時應特彆註意是否存在創傷性腹膜後血腫,病情允許時可行CT檢查明確腹膜後血腫的存在及有無腹腔髒器損傷,準確掌握創傷性腹膜後血腫的治療原則,嚴格把握手術指徵及腹膜後血腫探查的適應證,以輓救生命,減低病死率.
목적 탐토창상성복막후혈종(TRH)적진단、치료방법급예후정황.방법 회고성분석75례창상성복막후혈종환자적완정림상자료.결과 62례수술환자중사망5례,점수술환자적8.1%,57례전부치유.기중1례인도자상도치비혈관단렬、복주동맥손상,우술중사우실혈성휴극,루계실혈량체5 000 ml;1례반유중도로뇌손상,사우뇌산.령3례사우술후다기관공능쇠갈.13례보수치료자치유출원.총체치유70례,치유솔체93.3%.결론 재다발성창상시응특별주의시부존재창상성복막후혈종,병정윤허시가행CT검사명학복막후혈종적존재급유무복강장기손상,준학장악창상성복막후혈종적치료원칙,엄격파악수술지정급복막후혈종탐사적괄응증,이만구생명,감저병사솔.
Objective To explore the diagnosis,treatment and prognosis situation of traumatic retroperitoneal hematoma(TRH). Methods The full clinical data of 75 patients with TRH were retrospectively analyzed. Results 5 cases of 62 surgical patients died,accounted for surgery patients more than 8.1%.57 cases all cured.Including one for knife led to the rupture of the spleen vessel,abdominal aortic injury,surgery died in hemorrhagic shock,the cumulative loss amounted to 5 000ml;1 case with severe traumatic brain injury,died of a cerebral herniation.The other 3 cases died of cancer and multiple organ failure.13 cases of conservative treatment of all discharged.70 cases were cured,the cured rate was 93.3%. Conclusion Multiple trauma should pay special attention the existence of TRH.When conditions allowed,CT examination should be taken to clear the presence of retroperitoneal hematoma and the presence of abdominal organ injuries,and accurate knowledge of the principles of TRH treatment,strictly control surgical indications and retroperitoneal hematoma detection indication should be grasped to save lives and reduce mortality.
