Asbun H J, Irani H, Roe E J, Bloch J H
Department of Surgery, Kern Medical Center, Bakersfield, California.
J Trauma. 1990 Feb;30(2):189-93.
The use of seatbelts has significantly decreased the mortality and morbidity of injuries caused by motor vehicle accidents. We present eight patients who sustained severe intra-abdominal injuries peculiar to the use of the seatbelt. Serious injuries to the bowel and mesentery may be present without early symptoms or physical signs and neither CT scanning nor diagnostic peritoneal lavage is fully reliable or accurate in finding the injury. Prompt diagnosis may be difficult and requires a high index of suspicion as well as a determined approach that may include exploratory celiotomy. The presence of a seatbelt sign across the abdomen is not incontrovertible evidence that a laparotomy must be done, but its presence should create a high index of suspicion for serious visceral injury. Delay in diagnosis significantly increases morbidity and is associated with high mortality rates.
安全带的使用显著降低了机动车事故所致损伤的死亡率和发病率。我们报告8例因使用安全带而遭受严重腹部内伤的患者。肠道和肠系膜的严重损伤可能在早期没有症状或体征，CT扫描和诊断性腹腔灌洗在发现损伤方面都不完全可靠或准确。及时诊断可能困难，需要高度的怀疑指数以及包括剖腹探查术在内的果断方法。腹部有安全带痕迹并非必须进行剖腹手术的确凿证据，但它的出现应引起对严重内脏损伤的高度怀疑。诊断延迟会显著增加发病率，并与高死亡率相关。
