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[生长期的腹部创伤与骨盆损伤]

[Abdominal trauma and pelvic injury in the growth period].

作者信息

Rieger H, Neumann H S, Klein W, Winde G

机构信息

Klinik und Poliklinik für Unfall- und Handchirurgie, Westfälische Wilhelms-Universität Münster.

出版信息

Chirurg. 1996 Mar;67(3):261-7.

PMID:8681701
Abstract

Children with pelvic fractures usually are polytraumatized. Concomitant abdominal and pelvic injuries are not uncommon. Medical records and X-rays of 54 children, in which a pelvic fracture was diagnosed at our institution from 1974-1993, were reviewed. Children ages < or = 16 years and treated as in-patients were included in this study. The fractures were classified according to the AO-Classification. 47 patients (87.0%) had concomitant injuries. The mean Polytrauma Score was 23.7 (mean Injury Severity Score 30.5). Nine Children sustained an open pelvic fracture with rectal and/or vaginal tear. 15 genitourinary lesions were found in 13 children. 18 patients underwent laparotomy. A large pelvic/retroperitoneal hematoma was found in 11 cases. There were 7 liver lacerations, 7 splenic injuries, 2 mesenteric tears, 2 kidney injuries and 1 small bowel lesion. Eight children (14.8%) died with 5 of them due to retroperitoneal or/and abdominal bleeding complications. A recent follow-up examination (81.8%) with a mean follow-up of 11.3 years showed that long-term morbidity usually was attributed to pelvic concomitant injuries.

摘要

骨盆骨折的儿童通常为多发伤。腹部和骨盆合并损伤并不少见。我们回顾了1974年至1993年间在我院诊断为骨盆骨折的54例儿童的病历和X线片。本研究纳入年龄≤16岁且接受住院治疗的儿童。骨折根据AO分类法进行分类。47例患者(87.0%)有合并损伤。多发伤平均评分为23.7(损伤严重度评分平均为30.5)。9例儿童发生开放性骨盆骨折并伴有直肠和/或阴道撕裂伤。在13例儿童中发现15处泌尿生殖系统损伤。18例患者接受了剖腹手术。11例发现有巨大骨盆/腹膜后血肿。有7例肝裂伤、7例脾损伤、2例肠系膜撕裂伤、2例肾损伤和1例小肠损伤。8例儿童(14.8%)死亡,其中5例死于腹膜后或/和腹部出血并发症。最近的一次随访检查(81.8%),平均随访11.3年,结果显示长期发病率通常归因于骨盆合并损伤。

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