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印度北部队列钝性腹部创伤的频率、模式及原因评估:一项基于尸检的研究

Assessment of Frequency, Patterns, and Causes of Blunt Abdominal Trauma in a North Indian Cohort: An Autopsy-Based Study.

作者信息

Ranjan Saroj Kumar, Singh Ritesh Kumar, Kumar Sanjeev, Kumari Pinki

机构信息

Forensic Medicine and Toxicology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, IND.

Forensic Medicine and Toxicology, Nalanda Medical College and Hospital (NMCH), Patna, IND.

出版信息

Cureus. 2023 Sep 7;15(9):e44856. doi: 10.7759/cureus.44856. eCollection 2023 Sep.

Abstract

Introduction The abdomen is one of the most frequently damaged areas in trauma patients and is commonly encountered in road traffic accidents (RTAs). The present study evaluates the frequency, etiology, causation, and form of injury in blunt abdominal trauma (BAT) cases who had autopsies. Method An autopsy-based observational prospective study was conducted at the Department of Forensic Medicine and Toxicology, Nalanda Medical College and Hospital Patna, India, during the period from October 2018 to September 2020, which included a total of 940 autopsy cases showing blunt abdominal injuries. A predesigned proforma for the postmortem evaluation of BAT victims was used to collect the required information on the cases. Descriptive statistics were performed, and the data were presented as frequency (%) and mean±SD. Chi-square tests were performed to compare categorical variables between groups. Results BAT accounted for 120 (12.76%) cases of all autopsies performed. The majority of victims were male (92.48%). Victims aged 21-30 years (31, 25.83%) were the ones most usually engaged in BAT cases. Among the mechanisms accountable for BAT, RTAs were the most common (99, 82.50%), followed by assault (16, 13.30%). In most of the cases, the liver was injured (107, 89.16%), followed by the spleen (60, 50.00%) and kidney (24, 20.00%). The majority of blunt abdominal injury-related deaths were accidental (100, 83.33%), followed by homicidal (15, 12.5%) and suicidal cases (5, 4.17%). Hemorrhage and neurogenic shock were the most prevalent causes of mortality, particularly if the individual died within a few hours. Conclusion RTAs are the most frequent cause of BAT in autopsy cases, and the liver is the most affected organ. The majority of deaths occur within the first 24 hours of injury. Since blunt abdominal injuries have the propensity to increase morbidity and mortality, appropriate emphasis on their precise diagnosis and satisfactory therapy is mandated.

摘要

引言

腹部是创伤患者中最常受损的部位之一,在道路交通事故(RTA)中很常见。本研究评估了接受尸检的钝性腹部创伤(BAT)病例的损伤频率、病因、成因和形式。

方法

2018年10月至2020年9月期间,在印度巴特那那烂陀医学院和医院法医学与毒理学系进行了一项基于尸检的观察性前瞻性研究,共纳入940例显示钝性腹部损伤的尸检病例。使用预先设计的BAT受害者尸检评估表格收集病例所需信息。进行描述性统计,数据以频率(%)和均值±标准差表示。进行卡方检验以比较组间分类变量。

结果

BAT占所有尸检病例的120例(12.76%)。大多数受害者为男性(92.48%)。21至30岁的受害者(31例,25.83%)是最常发生BAT病例的人群。在导致BAT的机制中,RTA最为常见(99例,82.50%),其次是袭击(16例,13.30%)。在大多数病例中,肝脏受损(107例,89.16%),其次是脾脏(60例,50.00%)和肾脏(24例,20.00%)。大多数与钝性腹部损伤相关的死亡为意外(100例,83.33%),其次是他杀(15例,12.5%)和自杀病例(5例,4.17%)。出血和神经源性休克是最常见的死亡原因,尤其是个体在数小时内死亡的情况。

结论

在尸检病例中,RTA是BAT最常见的原因,肝脏是受影响最严重的器官。大多数死亡发生在受伤后的头24小时内。由于钝性腹部损伤有增加发病率和死亡率的倾向,因此必须适当重视其准确诊断和满意治疗。

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