摘要
目的:探讨胸腹联合伤(TACI)伴膈肌破裂的临床特点及诊治方法。方法:总结经手术证实的TACI82例,其中开放性损伤36例(36.90%),以锐器刺伤为主;闭合性损伤46例(63.10%),以交通伤多见。分析不同原因的损伤类别、损伤器官、诊治方法。结果:本病伤情复杂,常为多器官损伤,82例中术前明确有膈肌破裂38例(46.34%);78例在第一次手术中发现膈肌破裂,并予以修补(95.12%),4例漏诊膈肌损伤(4.88%);死亡11例(13.41%)。结论:TACI是一种特殊类型的损伤,伤情复杂、严重,死亡率高。治疗原则为早期确诊、及时正确的手术治疗,先处理胸部损伤,后处理腹内脏器损伤。
Objective：To study the clinical features and treatment experience in the treatment of thoracoabdominal combined injury （TCI） with diaphragmatic rupture.Methods：A retrospective study was carried out in 82 cases of TCI treated surgi cally.Among them,there were 36 cases （36.90%） with penetrating injury caused by sharp instrument and 46（63.10%） with blunt injury.Traffic injury was commonly seen.The injuries due to different causes and with diaphragmatic rup ture were analysed retrospectively.Results：This kind of injuries was usually complicated by multiple organ injuries.Of 82 cases,38 （46.34%） had diaphragmatic ruptures preoperatively,78 （95.12%） diaphragmatic rupture was found in the first operation and was repaired;4 （4.88%） were missed diagnosis of diaphragmatic injuries and 11 （13.41%） died.Conclusion：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 avoid the missed diagnosis of diaphragmatic injuries.The treatment principle is early diagnosis and timely operation,thoracic injury first and laparotomy second.
出处
《现代医药卫生》
2010年第18期2742-2744,共3页
Journal of Modern Medicine & Health
关键词
胸腹联合伤
膈肌破裂
Thoracic injuries
Abdominal injuries
Diaphragm
