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Diagnosis and Treatment of Closed Abdominal Trauma (Report of 78 Cases )

目的　 總結腹部閉合性損傷的診治體會。方法　 回顧性分析我院78例腹部閉合性損傷患者的臨床資料。結果　78例中67例手術治療，4例行腎動脈栓塞術，7例保守治療； 除1例死亡外，余均治愈。結論　及時診斷和治療是救治腹部閉合性損傷患者的關鍵，腹腔穿刺、B超、CT及X線檢查的合理應用對診斷有重要價值。

COMPARISON ABOUT THE CHANGE OF PLASMA CORTISOL IN PREOPERATIVE AND POSTOPERATIVE PERIOD BETWEEN ABDOMINAL EMERGENCY PATIENTS AND PLANNED-OPERATION PATIENTS

Plasma cortisols in 18 abdominal emergency patients and 20 planned-operation patients were examined. The result showed that cortisols in planned-operation patients were increased after their operations. On the other hand, plasma cortisols in emergency patients were higher in preoperative period than that in the postoperative period. There were no furher increase after operations. The changes of plasma cortisols between two kinds of patients were very different. This means that stress reactions in the patient with acute abdomen can be reduced by early operations.

Pulmonary Complications and Infection of Urinary System after Abdominal Surgery

超聲診斷婦科急腹癥

【摘要】 目的 總結經腹部B超在婦科急腹癥診斷中的應用。方法 回顧分析2007年1月—2009年3月115例婦科急腹癥患者的腹部B超檢查資料,并將超聲結果與最后臨床診斷結果進行對比。結果 經腹部超聲診斷婦科急腹癥的總誤診率7.83%,總符合率為92.17%。結論 腹部超聲對婦科急腹癥的診斷準確性高,對于超聲聲像圖特征不明顯者,應結合患者的病史及實驗室檢查,可提高診斷準確性。

損傷控制外科在嚴重腹部創傷中的臨床應用

目的 探討損傷控制外科（damage control surgery，DCS）在救治嚴重腹部創傷患者中的臨床應用。 方法 回顧性分析 2013 年 4 月至 2015 年 4 月解放軍總院海南分院采用 DCS 理念（簡單快速手術、液體復蘇和確定性手術）救治的 40 例嚴重腹部創傷患者的臨床資料。總結應用損傷控制理念救治嚴重腹部創傷的適應證和治愈率。 結果 40 例患者中痊愈 35 例，治愈率為 87.5%；死亡 5 例，死亡率為 12.5%。 結論 應用損傷控制理念救治嚴重腹部創傷為比較安全的救治方法，可有效提高臨床治愈率。

腹部外科急癥1385例救治分析

Analysis on Diagnosis and Treatment about Laparoscopy for Abdominal Trauma and Gastrointestinal Injury

目的探討腹腔鏡在腹部外傷并胃腸道損傷中的診治作用。 方法對我院2005年1月至2010年6月期間60例行腹腔鏡手術治療的腹部外傷并胃腸道損傷患者的臨床資料，以及腹腔鏡手術入路及術中處理情況進行回顧性分析。 結果60例患者均經腹腔鏡手術證實為胃腸道損傷，根據損傷的具體情況，行完全腹腔鏡手術20例、腹腔鏡下輔助手術40例，其中行胃腸穿孔修補術45例,腸段切除術15例。 所有患者均順利完成手術，無術后胃腸道瘺和腹腔出血情況，有2例患者術后出現切口感染，經換藥后治愈。 結論 腹腔鏡在腹部外傷并胃腸道損傷方面的診斷價值確切，治療效果滿意，避免了不必要的剖腹手術，且創傷小，是一種安全、合理的手術方式。

ELECTROLYTE CHANGES BEFORE AND AFTER SCHEDULED ABDOMINAL SURGERY AND THE EFFECT OF PROMPT POTASSIUM SUPPLEMENT ON GASTROINTESTINAL FUNCTIOIN

In order to observe electrolyte changes before and after scheduled abdominal surgery and effect of prompt potassium supplement on the recovery of gastrointestinal function, electrolytes in 69 patients were tested before and after surgery, and the recovery of the gastrointestinal function was observed.The results showed that after surgery the levels of K＋, Na＋ and Cl＋ were decreased dramatically (Ｐ＜0.05) but still within the normal range, with no distinctive change in Ca２＋ and Mg２＋. No correlation between the amount of blood transfusion and potassium was detected. Prompt potassium supplement contributed to the quick recovery of gastrointestinal function.This suggests that with normal renal function, blood transfusion during the operation will not cause hyperkalemia, potassium supplement might begin on the first day when the patient begins to urinale.

CT Scan Diagnosis in Gastrointestinal Tract Rupture after Blunt Abdominal Trauma

Objective To evaluate the role of CT in diagnosis of the gastrointestinal tract rupture after blunt abdominal trauma. MethodsTwenty preoperative CT scans and clinical data were obtained in 20 patients who subsequently had bowel ruptures verified surgically. CT findings were analyzed retrospectively in these patients. Retrospective interpretation was made by consensus of at least two radiologists. ResultsTwenty cases of CT scan showed intraperitoneal fluid (18 cases), pneumoperitoneum (18 cases), extravasations of gastrointestinal tract contents (2 cases), bowel wall findings (14 cases) and mesenteric injury (15 cases). Conclusion CT is fast, sensitive and noninvasive in diagnosis of the gastrointestinal tract rupture after blunt abdominal trauma.

Laparoscopic Diagnosis and Treatment for the Acute Abdomen and Abdominal Trauma