108例外伤性小肠破裂的临床分析.DOCVIP

临床医学论文-108例外伤性小肠破裂的临床分析 【关键词】? 腹外伤 　　摘? 要：目的：进一步提高对外伤性小肠破裂的治疗水平。方法：收集1995年至2004年间我市人民医院、中医院、保健院诊治的外伤性小肠破裂108例，对致伤原因、诊断、治疗方法、并发症等进行统计分析。结果：交通事故伤48例，占44.44%，坠落伤21例，占19.44%，撞击伤19例，占17.59%，踢伤9例，占8.33%，刀刺伤8例，占7.41%，其它伤3例，占2.78%。并发切口感染9例，肠粘连4例，多器官功能不全综合征（MODS）3例，切口裂开及肺部感染各2例。治愈105例，死亡3例。死亡原因均为合并伤伴创伤性休克或感染性休克，导致MODS。结论：早期诊断、及时手术，选择合适的手术方式，彻底的冲洗和合理的引流，早期应用抗生素，重视整体治疗等均为减少并发症、降低病死率的重要因素。 　　关键词：腹外伤；早期诊断；小肠破裂　　　Clinical Analysis of 108 Cases Intestinal Rupture 　　HUANG Mu-shou 　　(The Woman and Children Health Care Hospital of Huazhou, Guangdong Huazhou 525100, China) 　　Abstract: Objective: To improve the technology in treating intestinal rupture. Method: 108 cases with intestinal rupture were adopted in our local hospital. We analyzed stastically the trauma causes diagnosis treatment and complication. Result: The occupied rate of traffic accident injury of falling collision injury kick in?knife wound and otherinjuries is 44.44% (48 cases), 19.44% (21 cases), 17.59%(19 cases),8.33%(9 cases),7.41%( 8 cases),2.78%(3 cases) respetively 9 cases complicated with incision infection, 4 cases with intestinal adhesion. 3 cases with mods. 2 cases with incision rupture and lung infection. 105 cases were cured. 3 cases were dead. The death causes was MODS resulted from traumatic and infections shock. Conclusion: For the intestinal rupture patients early diagnosing and suitable operation rising throughly and suitable drainage early using antibiotics which can decrease the complication and death rate. 　　Key words:? Abdominal trauma;? Early diagnose;? Intestinal rupture 　　在腹部外伤中，外伤性小肠破裂比较常见［1］，虽然临床诊断并不困难，仍有延误治疗和处理不当而造成严重后果的病例。本文综合我市人民医院、中医院、保健院诊治的外伤性小肠破裂108例，作临床统计分析。 　　1? 资料与方法 　　1.1? 临床资料：本组外伤性小肠破裂共108例，其中人民医院77例、中医院26例、保健院5例。男69例，女39例。年龄6～75岁。伤后至入院时间最短0.5h，最长6d。 　　1.2? 方法：收集1995年至2004年间我市人民医院、中医院、保健院诊治的外伤性小肠破裂病例，对致伤原因、损伤情况、诊断、治疗方法、并发症、病死率等进行统计分析。 　　2? 结? 果 　　外伤性小肠破裂共108例 　　2．1? 致伤原因：交通事故伤48例，占44.44%，坠落伤21例，占19.44%，撞击伤19例，占17.59%，踢伤9例，占8.33%，刀刺伤8例，占7.41%，其它伤3例，占2.78%。 　　2．2? 脏器损伤情况：小肠破裂1处6