摘要
目的 分析术中术后出血的原因。方法 采用病例回顾的方法讨论了 48例术中和术后近期大出血病例的原因及外科处置。结果 分析表明 ,技术性操作失误 (14/48,2 9 2 % ) ,思想松懈 ,手术不仔细、不认真等主观因素所致出血 (8/48,16 7% ) ,解剖层次不清晰 (8/48,16 7% ) ,凝血功能障碍 (6 /48,12 5 % ) ,胃应激性溃疡(6 /48,12 5 % ) ,术式选择不当 (2 /48,4 2 % ) ,其它原因 (4 /48,8 3% )等是造成术中和术后近期大出血的主要原因。手术止血成功 36例 (36 /48,75 % ) ,非手术止血成功 9例 (9/48,18 8% )。共 3例 (3/48,6 3% )死亡 ,其中手术止血 2例 ,非手术止血 1例。手术止血方法主要为缝扎、电凝、胶粘、填塞、切除等。结论 可有效避免术中和术后近期大出血 ,其关键在于医生增强责任心。
Objective To analyze the causes of intraoperative and postoperative hemorrhage in general surgery.Methods 48 cases of intraoperative and postoperative hemorrhage in general surgery were retrospectively analyzed for identification of hemorrhage causes and therapeutic effects of surgical approaches.Results It was demonstrated that the main causes of intraoperative and postoperative hemorrhage were surgical technique errors (14/48, 29.2%),subjective ignorance(8/48,16 7%),wrong anatomical assurance(8/48,16 7%),dysfunction of coagulation (6/48, 12 5%),stress ulcer(6/48,12 5%),improper selection of surgical procedure(2/48,4 2%) and others (4/48,8 3%).Hemostasis was achieved with surgical approaches(36/48,75%) and non-surgical approaches(9/48,18 8%).A total of 3 cases died,including 2 with surgical approaches and 1 with non-surgical approaches.Surgical interventions included suture and ligation,glue adhesion,electric coagulation,tamponade,resection,etc. Conclusion Intraoperative and postoperative massive hemorrhage are able to be avoided completely as long as the operators take the responsibility and improve the manipulation techniques.
出处
《中国实用外科杂志》
CSCD
北大核心
2001年第6期344-346,共3页
Chinese Journal of Practical Surgery
关键词
围手术期
手术后
出血
病因
Perioperative stage\ Operation Hemorrhage
