Aragón G E, Eiseman B
J Trauma. 1976 Oct;16(10):792-7.
This paper reviews a 30-month experience with 172 patients suffering abdominal stab wounds treated at the Denver General Hospital, during a period when policy included liberal sinography and all penetrating injuries were explored. Laparotomy was performed in 87%. Of the 65 patients undergoing sinography, 62% indicated peritoneal penetration; of these, 30% had no visceral injury. An additional 10%, with minor intraperitoneal injuries, probably would not have required celiotomy. In 25 cases the stab penetrated the peritoneal cavity after first entering the chest. Peritoneal tap and peritoneal lavage were used in 10 patients. It is concluded that the cost/benefit ratio of sinography is so poor that it is rarely indicated. When doubt exists as to significant intraperitoneal pathology following an abdominal stab wound, close observation without sinography is recommended for determining indication for laparotomy.
本文回顾了丹佛总医院对172例腹部刺伤患者长达30个月的治疗经验，在此期间的政策包括广泛使用窦道造影术，且对所有穿透伤均进行探查。87%的患者接受了剖腹手术。在65例行窦道造影术的患者中，62%显示有腹膜穿透；其中，30%没有内脏损伤。另外10%有轻微的腹腔内损伤，可能原本就不需要进行剖腹术。有25例刺伤先进入胸部后再穿透腹腔。10例患者使用了腹腔穿刺和腹腔灌洗。得出的结论是，窦道造影术的成本效益比很差，很少有必要进行。当腹部刺伤后对是否存在明显的腹腔内病变存在疑问时，建议不进行窦道造影术而密切观察，以确定是否需要进行剖腹手术。
