Chmielewski G W, Nicholas J M, Dulchavsky S A, Diebel L N
Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan.
Am Surg. 1995 Aug;61(8):665-8.
Nonoperative management of stab wounds of the abdomen is currently practiced in many trauma centers; this report examines the role of expectant management of gunshot wounds to the abdomen in a select patient population. Patients presenting to a single trauma service from 5/91 to 1/94 at Detroit Receiving Hospital with a gunshot wound (GSW) to the abdomen fulfilling the following criteria were observed: 1) single GSW to the right upper quadrant, 2) stable vital signs, 3) reliable examination with minimal abdominal tenderness and available team/operating room, and 4) minimal or no abdominal tenderness. There were 12 patients fulfilling the study criteria; all were successfully observed. One nontherapeutic laparotomy was done due to abdominal tenderness. The role of expectant therapy of abdominal gunshot wounds is cautiously advanced. With appropriate criteria, this technique appears safe and efficacious.
目前，许多创伤中心都采用非手术方法处理腹部刺伤；本报告探讨了对特定患者群体的腹部枪伤进行保守治疗的作用。观察了1991年5月至1994年1月期间在底特律接收医院单一创伤科就诊、腹部枪伤符合以下标准的患者：1）右上腹单发枪伤；2）生命体征稳定；3）体格检查可靠，腹部压痛轻微，且有团队/手术室可用；4）腹部压痛轻微或无压痛。有12例患者符合研究标准；所有患者均成功接受观察。1例因腹部压痛进行了非治疗性剖腹手术。腹部枪伤保守治疗的作用得到谨慎推进。符合适当标准时，该技术似乎安全有效。
