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钝性小肠创伤

[Blunt small intestinal trauma].

作者信息

Wu C L, Chou M C

机构信息

Department of Surgery, Kuang Tien General Hospital, Taichung, Taiwan, Republic of China.

出版信息

Gaoxiong Yi Xue Ke Xue Za Zhi. 1993 Mar;9(3):169-77.

PMID:8510200
Abstract

From 1986 to 1990, 41 patients with blunt small intestinal trauma were hospitalized and underwent surgery in Kuang Tien General Hospital. Included were 34 males and 7 females with a mean age of 37 years (range: 8 to 67). The mean duration of follow-up was 41 months. We classified the severity of small intestinal injury with the duodenum organ injury scale or small bowel organ injury scale published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A. A. S. T.) in 1990. According to the operative findings, the small intestinal injuries of the 41 cases were classified as follows: grade I-11 cases, grade II-16 cases, grade III-8 cases, grade IV-2 cases, and grade V-7 cases. Three cases had both duodenal and small bowel injuries. Among the patients, 4 cases were treated by drainage. Seven cases underwent simple repair. Three cases were treated with repair and drainage. Thirteen cases underwent enterorrhaphy and drainage. Seventeen cases were treated with resection and anastomosis. The mortality rate was 7.2%, whilst the morbidity rate was 34.0%. The most frequent postoperative complications related to the small intestinal injury in patients who survived the initial operation were wound infection (22.0%), intra-abdominal abscesses (4.8%), pulmonary infection (4.8%), and small bowel obstruction (2.4%).

摘要

1986年至1990年期间,41例钝性小肠创伤患者在广田综合医院住院并接受手术治疗。其中男性34例,女性7例,平均年龄37岁(范围:8至67岁)。平均随访时间为41个月。我们采用美国创伤外科协会(A.A.S.T.)器官损伤分级(O.I.S.)委员会1990年发布的十二指肠器官损伤分级或小肠器官损伤分级对小肠损伤的严重程度进行分类。根据手术结果,41例小肠损伤分类如下:Ⅰ级11例,Ⅱ级16例,Ⅲ级8例,Ⅳ级2例,Ⅴ级7例。3例同时存在十二指肠和小肠损伤。患者中,4例采用引流治疗。7例行单纯修补术。3例采用修补加引流治疗。13例行肠修补加引流术。17例行切除吻合术。死亡率为7.2%,发病率为34.0%。初次手术后存活患者中与小肠损伤相关的最常见术后并发症为伤口感染(22.0%)、腹腔脓肿(4.8%)、肺部感染(4.8%)和小肠梗阻(2.4%)。

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