創(chuàng)傷性脾破裂的臨床急救分析
發(fā)布時(shí)間:2018-06-24 來(lái)源: 感悟愛(ài)情 點(diǎn)擊:
【摘要】 目的:探析創(chuàng)傷性脾破裂的臨床急救情況。方法:回顧性分析2014年4月-2017年4月筆者所在醫(yī)院收治的126例創(chuàng)傷性脾損傷患者的一般資料及臨床相關(guān)資料,包括患者手術(shù)情況(手術(shù)時(shí)間、出血量等)或其他治療情況、住院時(shí)間等,并探討分析。結(jié)果:本次126例患者中,保守治療35例,占27.78%;手術(shù)治療91例,占72.22%。保守治療的35例患者中,1例因情況危及轉(zhuǎn)手術(shù)治療,1例出現(xiàn)感染。91例手術(shù)治療的患者中,單純實(shí)施縫合術(shù)治療39例,部分切除聯(lián)合縫合38例,全切術(shù)14例。126例患者均經(jīng)積極治療后出院;颊咂骄中g(shù)時(shí)間(53.76±10.89)min;平均出血量為(785.72±187.92)ml;平均住院時(shí)間為(14.29±2.71)d。結(jié)論:創(chuàng)傷性脾破裂的臨床急救工作的開(kāi)展有效提高患者的治療效果,對(duì)癥治療,減少住院時(shí)間,提高預(yù)后,通過(guò)對(duì)實(shí)際病例的分析利于總結(jié)經(jīng)驗(yàn),將臨床急救工作發(fā)揮更好。
【關(guān)鍵詞】 創(chuàng)傷性脾破裂; 臨床急救; 手術(shù)情況分析
doi:10.14033/j.cnki.cfmr.2018.5.080 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805(2018)05-0155-03
【Abstract】 Objective:To investigate the clinical emergency treatment of traumatic splenic rupture.Method:Data of 126 cases of traumatic splenic injury were retrospectively analyzed from April 2014 to April 2017 in our department and relevant clinical data including patient operation(operation time,amount of bleeding) or other treatment,hospitalization time,and analysis.Result:In the 126 cases,35 cases were conservatively treated,accounting for 27.78%.91 cases were treated by surgery,accounting for 72.22%.Of the 35 patients who had been treated conservatively,1 had undergone surgical treatment,and 1 had an infection.Of the 91 cases treated by operation,39 cases were treated with suture only,38 cases were treated with partial resection and suture,14 cases underwent total resection.126 patients were discharged from hospital after active treatment.The average operation time was (53.76±10.89)min,the average blood loss was (785.72±187.92)ml,the average length of stay was (14.29±2.71)d.Conclusion:The clinical emergency treatment of traumatic splenic rupture effectively improve patient outcomes,symptomatic treatment,reduce hospitalization time,improve the prognosis,through the analysis of actual cases to summarize the experience of clinical emergency work,will play better.
【Key words】 Traumatic spleen rupture; Clinical first aid; Operation analysis
First-author’s address:Chongqing Three Gorges Central Hospital,Chongqing 404000,China
創(chuàng)傷性脾破裂是臨床較為兇險(xiǎn)的疾病,由于其脾臟的特殊生理結(jié)構(gòu),其內(nèi)部含有豐富的血竇血管,血流豐富,所以出現(xiàn)創(chuàng)傷性脾破裂時(shí),容易發(fā)生快速的大量出血,從而導(dǎo)致患者出現(xiàn)失血性休克,因而,在患者入院后,給予迅速及時(shí)地?fù)尵,在很大程度上不但能減少病死率,同時(shí)還能為手術(shù)贏得時(shí)間,對(duì)患者的病情控制具有非常重要的意義[1-3]。因此,早確診、早手術(shù),積極抗休克、擴(kuò)容、糾正酸中毒并抗感染等是搶救成功的關(guān)鍵。本文總結(jié)了2014年4月-2017年4月筆者所在醫(yī)院接診的126例創(chuàng)傷性脾破裂患者的臨床急救情況,具體見(jiàn)如下報(bào)道。
1 資料與方法
1.1 一般資料
回顧性分析筆者所在醫(yī)院2014年4月-2017年4月接診的126例創(chuàng)傷性脾損傷的患者的臨床資料,男69例,女57例;年齡12~79歲,平均(43.29±6.29)歲;致傷因素:交通因素89例,高空墜落17例,撞擊閉合性11例,尖銳物體刺入開(kāi)放傷9例;受傷至就診時(shí)間0.8~5.6 h。所有患者均經(jīng)CT、超聲或手術(shù)確診。按照以下脾損傷分級(jí)標(biāo)準(zhǔn),Ⅰ級(jí)13例,Ⅱ級(jí)10例,Ⅲ級(jí)58例,Ⅳ級(jí)45例。64例合并失血休克,10例合并肝破裂,其他合并32例。入院時(shí)患者均有不同程度的躁動(dòng)不安、組織缺氧、急性微循環(huán)灌注不足、面色蒼白、出汗等表現(xiàn),血壓和體溫有不同程度下降。
相關(guān)熱詞搜索:破裂 急救 臨床 分析 創(chuàng)傷性
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