Muguti G I, Zishiri C, Dube M
Department of Surgery, Mpilo Central Hospital, Bulawayo, Zimbabwe.
Cent Afr J Med. 1995 Dec;41(12):380-5.
Between January 1989 and December 1992 a total of 102 patients (88 pc male and 12 pc female) were treated for stab wounds at Mpilo Central Hospital, Bulawayo, Zimbabwe. The case records of these patients have been studied retrospectively. The mean age of the patients was 30 years (Standard Deviation 9). Most of the patients, 82 pc (82/102) were residents of the city of Bulawayo with only 18 pc (18/102) coming from rural areas. The mean delay in presentation was 12 hours (SD 11). A knife was the stabbing instrument in most cases (82 pc). Fights, 38 pc (26/68), domestic disputes, 26 pc (18/68) and robbery 21 pc (14/68) were the commonest motives for stabbing. In most cases stabbing occurred in a beer hall, 47 pc (26/55) and at home, 31 pc (17/55). The majority of stab wounds occurred in the chest, 51 pc followed by the abdomen, 31 pc. Of the patients with stab wounds of the chest 22 pc (14/65) required intercostal chest drains. Of the 39 patients with stab wounds of the abdomen 20 patients were subjected to laparotomy. No abnormality was found at operation in 50 pc (10/20) of cases. No major complications or mortality were recorded in this series. Based on the findings in this study, there is need for us to adopt a more conservative approach to the management of stab wounds, especially those involving the abdomen. This policy of "selective conservatism" should be based on a thorough physical examination and appropriate special investigations. Active surgical intervention should be reserved for specific indications.
1989年1月至1992年12月期间，津巴布韦布拉瓦约市的姆皮洛中心医院共收治了102例刺伤患者（男性88例，女性12例）。对这些患者的病历进行了回顾性研究。患者的平均年龄为30岁（标准差9岁）。大多数患者，即82%（82/102）是布拉瓦约市居民，只有18%（18/102）来自农村地区。就诊的平均延迟时间为12小时（标准差11小时）。大多数情况下（82%）刺伤工具为刀。打架（38%，26/68）、家庭纠纷（26%，18/68）和抢劫（21%，14/68）是刺伤最常见的动机。大多数刺伤事件发生在啤酒馆（47%，26/55）和家中（31%，17/55）。大多数刺伤伤口位于胸部（51%），其次是腹部（31%）。胸部刺伤患者中有22%（14/65）需要进行肋间胸腔引流。在39例腹部刺伤患者中，20例接受了剖腹手术。50%（10/20）的病例在手术中未发现异常。该系列中未记录到重大并发症或死亡病例。基于本研究的结果，我们有必要对刺伤的处理采取更保守的方法，尤其是涉及腹部的刺伤。这种“选择性保守”政策应基于全面的体格检查和适当的特殊检查。积极的手术干预应保留用于特定指征。
