An experience with blunt abdominal trauma: evaluation, management and outcome.
An experience with blunt abdominal trauma: evaluation, management and outcome.
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DOI：
10.4081/cp.2014.599
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发表时间：
2014-06-18
影响因子：
2.3
通讯作者：
Venugopal K
中科院分区：
文献类型：
--
作者：
Mehta N;Babu S;Venugopal K
钝性腹部创伤（BAT）是一种常见的急诊疾病，尽管认识、诊断和治疗水平不断提高，但其发病率和死亡率仍很高。创伤是第二大疾病原因，占全球负担的16%。世界卫生组织估计，到2020年，创伤将成为全世界人口丧失生产性寿命的第一或第二大原因。本研究旨在评估71例BAT，强调早期诊断和治疗，增加非手术治疗的使用，以及患者的就诊时间。对18个月内在Kempegowda医学科学研究所医院（KIMS，班加罗尔，印度）住院的71例BAT患者进行了回顾性分析。研究了人口统计学资料、创伤机制、治疗和结局。我们研究中的大多数患者年龄在21-30岁之间，男女比例为3.7：1。机动车事故（53%）是最常见的损伤机制。脾脏（53%）是最常见的器官损伤，最常见的手术是脾切除术（30%）。最常见的腹部外损伤是肋骨骨折，占20%。死亡率为4%。伤口脓毒症（13%）是最常见的并发症。最初的复苏措施、彻底的临床检查和正确的诊断构成了治疗的最重要部分。70%的脾、肝、肾损伤可以保守治疗，而大多数中空脏器需要剖腹手术。患者就诊的时间与结果有很大关系。早期诊断和及时治疗可以挽救许多生命。
Blunt abdominal trauma (BAT) is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Trauma is the second largest cause of disease accounting for 16% of global burden. The World Health Organization estimates that, by 2020, trauma will be the first or second leading cause of years of productive life lost for the entire world population. This study endeavors to evaluate 71 cases of BAT with stress on early diagnosis and management, increase use of non operative management, and time of presentation of patients. A retrospective analysis of 71 patients of BAT who were admitted in Kempegowda Institute of Medical Sciences hospital (KIMS, Bangalore, India) within a span of 18 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Most of the patients in our study were in the age group of 21-30 years with an M:F ratio of 3.7:1. Motor vehicle accident (53%) was the most common mechanism of injury. Spleen (53%) was the commonest organ injured and the most common surgery performed was splenectomy (30%). Most common extra abdominal injury was rib fracture in 20%. Mortality rate was 4%. Wound sepsis (13%) was the commonest complication. Initial resuscitation measures, thorough clinical examination and correct diagnosis forms the most vital part of management. 70% of splenic, liver and renal injuries can be managed conservatively where as hollow organs need laparotomy in most of the cases. The time of presentation of patients has a lot to do with outcome. Early diagnosis and prompt treatment can save many lives.