Kent A L, Jeans P, Ewards J R, Byrne P D
Department of Surgery, Queen Elizabeth Hospital, Woodville, Adelaide, Australia.
Aust N Z J Surg. 1993 Oct;63(10):772-9. doi: 10.1111/j.1445-2197.1993.tb00339.x.
A ten year review of penetrating thoracic and abdominal trauma examined pattern of injury, patient management and outcome. Ninety-six patients were included in the study, 55 with injury to the abdomen, 31 the thorax and 10 with injury to both areas. Fifty-eight cases were managed non-operatively; 5 combined abdominal and thoracic injuries, 26 thoracic and 27 abdominal. Two cases went on to require operative management for intra-abdominal injury. Thirty-eight cases were managed operatively; 5 combined cavity injuries, 5 thoracic and 28 abdominal. Injuries were found in all of the combined cavity and thoracic cavity cases. Of the 28 abdominal cases, nine were found on laparotomy to have no significant visceral or vessel injury, one, however, was performed for omentum protruding through the wound. While a negative laparotomy was a relatively safe procedure, non-operative management had the advantages of a shorter hospital stay without wound-related morbidity. Selective non-operative management was found to be a relatively safe approach in this series.
一项关于穿透性胸腹部创伤的十年回顾性研究，对损伤模式、患者管理及预后进行了分析。该研究纳入了96例患者，其中55例腹部受伤，31例胸部受伤，10例胸腹部均受伤。58例患者接受非手术治疗，其中5例为胸腹联合伤，26例为单纯胸部损伤，27例为单纯腹部损伤。有2例因腹部损伤最终需要手术治疗。38例患者接受手术治疗，其中5例为胸腹联合伤，5例为单纯胸部损伤，28例为单纯腹部损伤。所有胸腹联合伤及单纯胸部损伤病例均发现有损伤。在28例腹部损伤病例中，9例经剖腹探查发现无明显内脏或血管损伤，不过有1例因网膜经伤口突出而进行了手术。虽然阴性剖腹探查是一种相对安全的手术，但非手术治疗具有住院时间短且无伤口相关并发症的优点。在本系列研究中，选择性非手术治疗被证明是一种相对安全的方法。
