Wu C L, Chou M C
Department of Surgery, Kuang Tien General Hospital, Sha-Lu, Taichung, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi. 1993 Sep;9(9):540-52.
From 1986 to 1990, 175 patients with blunt abdominal trauma were hospitalized and operated on in Kuang Tien General Hospital. Included were 140 males and 35 females with a mean age of 33 years (range: 2 to 82). The mean duration of the follow-up was 42 months. We classified the severity of the injured organs with the organ injury scale which was published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A. A. S. T.) in 1989 and 1990. Among the patients, 12 cases were treated with splenorrhaphy. Eighty-two cases underwent splenectomy. Four cases underwent partial resection of the liver. Three cases required repair of the inferior vena cava. Seventeen cases were treated with partial resection of the small intestine and anastomosis. Seven cases underwent colostomy. Three cases were treated with distal pancreatectomy. Nineteen cases underwent nephrectomy. One case was treated with partial nephrectomy. The mortality rate was 6.3%, and the morbidity rate 20.6%. The most frequent postoperative complications related to blunt abdominal trauma in the patients who survived the initial operation were wound infection (8.0%), small bowel obstruction (4.0%), pulmonary infection (2.3%), intra-abdominal abscesses (2.3%), pancreatitis (1.7%), pancreatic fistula (1.7%), and pseudocyst (0.6%).
1986年至1990年期间,175例腹部钝性创伤患者入住广田综合医院并接受了手术治疗。其中男性140例,女性35例,平均年龄33岁(范围:2至82岁)。平均随访时间为42个月。我们采用美国创伤外科学会(A.A.S.T.)器官损伤分级(O.I.S.)委员会于1989年和1990年发布的器官损伤量表对受损器官的严重程度进行分类。在这些患者中,12例接受了脾修补术。82例行脾切除术。4例行肝部分切除术。3例需要修复下腔静脉。17例行小肠部分切除吻合术。7例行结肠造口术。3例行胰体尾切除术。19例行肾切除术。1例行肾部分切除术。死亡率为6.3%,发病率为20.6%。在初次手术后存活的患者中,与腹部钝性创伤相关的最常见术后并发症为伤口感染(8.0%)、小肠梗阻(4.0%)、肺部感染(2.3%)、腹腔脓肿(2.3%)、胰腺炎(1.7%)、胰瘘(1.7%)和假性囊肿(0.6%)。