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目的探讨胸腹联合伤的院内急诊救治措施。方法回顾性分析62例经手术证实的胸腹联合伤患者的临床资料。结果全部病例均行胸腔闭式引流,剖腹手术31例,开胸手术10例,剖腹+开胸手术13例,胸腹联合切口7例,1例经胸壁创口扩大进行手术。治愈50例,死亡12例,原因为失血性休克8例、多器官功能衰竭3例、脑疝1例。结论胸腹联合伤伤情复杂、危重,最常见的死亡原因是失血性休克。限制性液体复苏、早期手术和恰当选择损伤控制性手术方式是提高重危胸腹联合伤病人抢救成功率的关键。
Objective To investigate the emergency treatment of intra-abdominal emergency of thoraco-abdominal injuries. Methods A retrospective analysis of 62 cases of surgically confirmed patients with thoracoabdominal injuries in clinical data. Results Thoracic drainage was performed in all cases. Laparotomy was performed in 31 cases, thoracotomy in 10 cases, laparotomy + thoracotomy in 13 cases, thoracoabdominal incision in 7 cases, and thoracic incision in 1 case. 50 cases were cured and 12 died. The reasons were hemorrhagic shock in 8 cases, multiple organ failure in 3 cases and cerebral hernia in 1 case. Conclusions Thoracoabdominal and joint injuries are complex and critically ill. The most common cause of death is hemorrhagic shock. Restrictive fluid resuscitation, early surgery and the proper choice of injury control surgery is to improve the critical success rate of thoracoabdominal injury patients critical success.