Demetriades D, Rabinowitz B, Sofianos C, Charalambides D, Melissas J, Hatzitheofilou C, Da Silva J
Department of Surgery, Medical School, Johannesburg, South Africa.
Ann Surg. 1988 Jan;207(1):72-4. doi: 10.1097/00000658-198801000-00014.
This is a prospective study of 230 patients with penetrating injuries of the back. The decision to operate or observe was taken exclusively on the abdominal physical findings. One hundred ninety-five patients (85%) did not require operation, 30 (13%) underwent a therapeutic laparotomy, four (1.7%) an unnecessary operation, and one patient (0.4%) had a completely negative laparotomy. The diagnosis and management was delayed in five (2.2%) patients with no serious consequences. Mortality rates were not recorded in this series. The initial physical examination was accurate in 95.2% of the patients. We suggest that penetrating injuries of the back should be assessed in the same way as anterior abdominal injuries. Physical abdominal examination is reliable in detecting significant intra-abdominal injuries.
这是一项针对230例背部穿透伤患者的前瞻性研究。手术或观察的决定完全基于腹部体格检查结果。195例患者（85%）无需手术，30例（13%）接受了治疗性剖腹手术，4例（1.7%）接受了不必要的手术，1例患者（0.4%）剖腹手术结果完全为阴性。5例（2.2%）患者的诊断和治疗有所延迟，但未造成严重后果。本系列未记录死亡率。95.2%的患者初始体格检查结果准确。我们建议，背部穿透伤应与前腹部损伤采用相同的评估方式。腹部体格检查在检测严重腹腔内损伤方面是可靠的。
