摘要
目的提高闭合性小肠损伤的诊治水平。方法对1993～2003年间诊治的闭合性小肠损伤48例进行回顾性分析。结果全组均有不同程度的腹痛及腹膜刺激征,腹穿阳性率58.3%,X线检查膈下游离气体出现率54.8%,B超检查腹腔积液出现率75%。治愈46例,死亡2例。结论(1)早期诊断闭合性小肠损伤必须对病史、临床表现及辅助检查进行分析,腹穿阴性及膈下未见游离气体并不能排除小肠穿孔。(2)早期手术治疗是提高外伤性肠破裂治愈率的关键。(3)强调手术探查必须细致、全面,按顺序进行,避免漏诊。
Objective To improve the diagnosis and treatment of closed injury of small intestine. Methods From 1993 to 2003,48 cases with closed injury of sma ll intestine were analyzed retrospectively.Results The abdominal pain and sign o f peritoneal irritation of different degree were found in all cases.The positive rate of peritoneo-centesis was 58 3%.The free air of subdiaphragm was in 54 8%.Hydroperitonia was found by ultrasound examination in 75%.46 cases were c ured,2 cases died from hemorrhagic shock.Postopereative complications were infec tion of incisional wound in 3 cases,intestinal adhesion in 1 case and pelvic abs cess in 2 cases.Conclusion The history,clinical manifestation and asisted examin ation are helpful for early diagnosis of closed injury of small intestine. The n egative of peritoneo-centesis and free air of subdiaphragm cann′t exclude the perforation of small intestine.Early surgical treatment is the key to improve th e cure rate of traumatic intestinal rupture.The exploratory laparotomy should be overall,careful and in turn examination to avoid misdiagnosis.
出处
《岭南现代临床外科》
2004年第1期23-24,共2页
Lingnan Modern Clinics in Surgery
