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目的 研究战时腹部火器伤的诊治。 方法 回顾分析我院 1979～ 1989年收治的2 81例腹部火器伤。 结果 早期诊断符合率 96 .8% (2 72 2 81) ,一线医院误诊率 3.2 % (9 2 81)。严重并发症有 :胃肠瘘 2 3例 (8.2 % ) ,腹腔脓肿 34例 (12 .1% ) ,切口感染 32例 (11.4% ) ,感染性休克 2 6例 (9.3% ) ,弥漫性血管内凝血 (DIC) 14例 (5 .0 % ) ,成人呼吸窘迫综合征 (ARDS) 8例(2 .8% ) ,机械性肠梗阻 6例 (2 .1% ) ,急性肾功能衰竭 4例 (1.4% ) ,气性坏疽 1例 (0 .4% )。治愈2 6 8例 (95 .4% ) ,死亡 13例 (4.6 % )。 结论 早期诊断忽视负伤史和腹部检查不仔细是误诊的主要原因 ,早期诊治不当是后期高并发症的重要因素。
Objective To study the diagnosis and treatment of firearm abdominal wounds in wartime. Methods A retrospective analysis of our hospital from 1979 to 1989 admitted 2 81 cases of abdominal firearm injuries. Results The coincidence rate of early diagnosis was 96.8% (2 72 2 81). The misdiagnosis rate of first-line hospital was 3.2% (9 2 81). Serious complications included 23 cases of gastrointestinal fistula (8.2%), 34 cases of abdominal abscess (12.1%), 32 cases of wound infection (11.4%), 26 cases of septic shock (9.3%), diffuse blood vessels There were 14 cases (5.0%) of internal coagulation (DIC), 8 cases (2.8%) of adult respiratory distress syndrome (ARDS), 6 cases of mechanical intestinal obstruction (2.1%) and 4 cases of acute renal failure (1.4%), 1 case of gas gangrene (0.4%). There were 268 cases (95.4%) cured and 13 (4.6%) died. Conclusion Early diagnosis of negligence history and abdominal examination is not carefully misdiagnosed as the main reason for improper early diagnosis and treatment of late complications is an important factor.