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外科手术患者的医疗问题。

Medical problems in surgical patients.

作者信息

Kasthuri A S, Nagpal B M, Handa A, Singh Y D

机构信息

Department of Medicine, Armed Forces Medical College, Pune 411 040.

出版信息

J Assoc Physicians India. 2000 Jul;48(7):695-9.

PMID:11273503
Abstract

OBJECTIVES

There has been an increase in surgical cases due to physical violence, accidents and weapon related injuries. This study was undertaken to assess the medical problems in general surgical cases and due to various injuries.

METHODS

All general surgical cases and casualties arising out of weapon related, accidents and blunt injuries admitted to a zonal hospital over a period of one and half years were studied. Only cases who developed a medical illness due to surgical cause, anaesthetic or surgery were included. Evaluation and treatment was done alongwith the surgeon till discharge/death. Details were analysed to ascertain the type of surgical illness, medical complication and the outcome of treatment.

RESULTS

There were seven hundred sixty two (53.8%) general surgery cases and six hundred fifty four (46.2%) cases due to various injuries. After excluding cases with prior known medical illness, thirty seven patients were studied. There were eight (1.05%) patients out of seven hundred sixty two general surgery cases and twenty nine (4.43%) out of six hundred fifty four injury cases. Weapon related injury cases were the maximum. Their medical problems related to the organ injury, fat embolism and sepsis. Soft tissue injury was next common, they all developed renal failure. Vehicle accident victim(3) were few and developed fat embolism, aspiration. Two patients out of thirty seven succumbed to post anaesthetic complications.

CONCLUSION

The incidence of medical problem in injury related cases are more than in general surgery cases. The type of injury contributes to the medical problem. Increase in mortality and morbidity is because of emergency nature of surgery. This problem needs special study.

摘要

目的

因身体暴力、事故和与武器相关的伤害导致的外科病例有所增加。本研究旨在评估普通外科病例以及因各种伤害导致的医疗问题。

方法

对一家地区医院在一年半时间内收治的所有因武器相关、事故和钝器伤导致的普通外科病例及伤亡情况进行研究。仅纳入因手术原因、麻醉或手术而引发医疗疾病的病例。在外科医生的配合下进行评估和治疗,直至患者出院或死亡。对详细情况进行分析,以确定外科疾病的类型、医疗并发症及治疗结果。

结果

共有762例(53.8%)普通外科病例和654例(46.2%)因各种伤害导致的病例。排除既往已知患有内科疾病的病例后,对37例患者进行了研究。在762例普通外科病例中有8例(1.05%),在654例伤害病例中有29例(4.43%)。与武器相关的伤害病例最多。其医疗问题与器官损伤、脂肪栓塞和脓毒症有关。软组织损伤次之,这些患者均出现肾衰竭。车祸受害者有3例,出现脂肪栓塞、误吸。37例患者中有2例死于麻醉后并发症。

结论

与伤害相关病例的医疗问题发生率高于普通外科病例。伤害类型导致了医疗问题。死亡率和发病率的增加是由于手术的紧急性质。这个问题需要进行专门研究。

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