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我院于1996年10月17日晚收治一例钢筋贯穿伤病人,男性,29岁,建筑工人。施工时被一长约4m、直径约2.5cm 的“螺纹钢筋”自20层楼上垂直坠落击伤。“螺纹钢筋”自左肩部刺入,经胸腔、腹腔及右下肢至右膝下6cm 胫侧穿出。急送我院。当时诉胸闷、腹痛。病人表情淡漠、出冷汗、畏寒、呕吐。血压12/8kPa(90/60 mmHg)、脉搏120次/分、呼吸25次/分。入院诊断:(1)开放性胸腹联合伤;(2)开放性骨盆骨折;(3)右下肢软组织挫裂伤。立即行胸腹探查术。术中见左胸腔内血性液体约2000ml、左肺不张,钢筋经左肩胛中线第七肋间穿通左下肺、膈肌进入腹腔。腹腔内有血性液体约1000ml,并有大量食物残渣。钢筋自食道裂孔处进入腹腔,在小网膜后刺破胃窦小弯,并经胃窦大弯侧穿出,刺破横结肠处系膜缘。自升结肠旁沟剪开侧腹膜,显露下腔静脉,于十二指肠球部上缘处
In our hospital on the evening of October 17, 1996, a case of reinforced penetrating wounds, male, 29 years old, construction worker was admitted. Construction was a length of about 4m, a diameter of about 2.5cm “rebar ” from the 20th floor vertical fall and wounded. “Threaded rebar ” pierced from the left shoulder, through the chest, abdomen and right lower extremity to the right knee 6cm out through the tibia. Urgent to our hospital. Chest tightness, abdominal pain. Patient expression indifferent, cold sweat, chills, vomiting. Blood pressure 12 / 8kPa (90/60 mmHg), pulse 120 beats / min, breathing 25 beats / min. Admission diagnosis: (1) open thoracoabdominal joint injury; (2) open pelvic fracture; (3) right lower extremity soft tissue contusion. Chest and abdomen exploration immediately. Intraoperative see the blood in the left chest about 2000ml, left atelectasis, the middle of the left shoulder through the middle of the seventh intercostal space through the lower left lung, diaphragm into the abdominal cavity. Abdominal bloody liquid about 1000ml, and a large number of food residue. Reinforcement from the esophageal hiatus into the abdominal cavity, in the small omentum punctures the lesser curvature of the antrum, and through the large curved side of the stomach piercing, puncture the Department of transverse colon Department of mesangial margin. Ascending colon colostomy cut the peritoneum, revealing the inferior vena cava, duodenal bulb in the upper edge