Stewart B T, Lee V, Danne P D
Royal Melbourne Hospital, Parkville, Australia.
Aust N Z J Surg. 1994 Jul;64(7):484-7. doi: 10.1111/j.1445-2197.1994.tb02261.x.
From 1983 to 1990, 110 patients with abdominal trauma required laparotomy in the Albury-Wodonga region. Splenic and liver injuries occurred in 50% of cases, and bowel trauma in 20%. The mortality rate was 8.2% (nine deaths) and major postoperative complications occurred in 18 patients (16%). Delay in therapeutic intervention of greater than 4 h from hospital admission led to a statistically significant increase in the complication rate (P < 0.01) despite a lower injury severity score in this group. Delayed repair of bowel injuries in particular led to an 80% major complication rate in survivors. A high index of clinical suspicion and the regular use of diagnostic peritoneal lavage is suggested to avoid such delays in diagnosis and subsequent surgery.
1983年至1990年期间，阿尔伯里-沃东加地区有110例腹部创伤患者需要接受剖腹手术。50%的病例发生脾损伤和肝损伤，20%的病例发生肠损伤。死亡率为8.2%（9例死亡），18例患者（16%）出现严重术后并发症。从入院起治疗干预延迟超过4小时，尽管该组损伤严重程度评分较低，但并发症发生率仍有统计学显著升高（P<0.01）。特别是肠损伤的延迟修复导致幸存者中严重并发症发生率达80%。建议保持高度的临床怀疑，并定期使用诊断性腹腔灌洗，以避免诊断和后续手术的此类延迟。
