腹部钝挫伤导致的中空内脏损伤:三级创伤中心的经验。

Adnan Özpek, Muhammed Kadir Yıldırak, Fikret Ezberci
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引用次数: 0

摘要

背景:在腹部钝性创伤患者中,空腔脏器损伤(HVIs)比实体脏器损伤更少出现,可能导致发病率和死亡率显著增加。现代成像设备可用于诊断实体器官损伤,但可能无法识别空腔脏器损伤。在本研究中,我们旨在介绍我们三级医疗中心在处理这种情况时的经验:本研究纳入了 2011 年 4 月至 2021 年 12 月期间在本诊所接受治疗的因腹部钝性创伤导致空腔脏器损伤的患者。我们在前瞻性数据库中记录并回顾性评估了患者的人口统计学数据、损伤部位和机制、术前和围手术期检查结果以及死亡率:结果:在 607 名钝性创伤患者中,35 人(5.8%)有空腔脏器损伤,其中 88.6% 为男性。机动车事故是主要致伤原因(80%)。从入院到手术探查的平均时间为 26±21.2 小时。平均受伤严重程度评分为(21.8±13.6)分。僵硬是最常见的临床表现(60%)。空肠和回肠是最常受伤的器官(54.1%)。死亡率和发病率分别为11.4%和17.1%:结论:入院 24 小时内白细胞(WBC)计数不下降,同时任何体格检查或放射学检查结果显示存在 HVI,应立即进行手术探查。
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Hollow viscus injury due to blunt abdominal trauma: a tertiary trauma center experience.

Background: Hollow viscus injuries (HVIs) present less frequently than solid organ injuries in patients with blunt abdominal trauma, potentially leading to significantly increased morbidity and mortality rates. Modern imaging equipment, confidently used for diagnosing solid organ injuries, may fail to identify hollow viscus injuries. In this study, we aim to present our tertiary center's experience with this entity.

Methods: Patients treated in our clinic from April 2011 to December 2021 for hollow viscus injury following blunt abdominal trauma were included in this study. We recorded and retrospectively evaluated patients' demographic data, injury site and mechanism, preoperative and perioperative findings, and mortality rates in a prospective database.

Results: Of the 607 blunt trauma patients, 35 (5.8%) had hollow viscus injuries, with 88.6% being male. Motor vehicle accidents were the leading cause of injury (80%). The mean duration between admission and surgical exploration was 26±21.2 hours. The mean Injury Severity Score was 21.8±13.6. Rigidity was the most frequent clinical finding (60%). The jejunum and ileum were the most frequently injured organs (54.1%). Mortality and morbidity rates were 11.4% and 17.1%, respectively.

Conclusion: Nondeclining white blood cell (WBC) counts within 24 hours of admission, alongside any physical or radiological finding indicating an HVI, should prompt immediate surgical exploration.

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