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时间:2019-05-22
《小儿外伤性小肠穿孔20例诊疗分析》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、临床小儿外科杂志2014年10月第13卷第5期JournalofClinicalPediatricSurgery,October2014,Vol.13,No.5·427··临床研究·小儿外伤性小肠穿孔20例诊疗分析冯召广陈肖鸣【摘要】目的探讨小儿外伤性小肠穿孔的早期诊断及手术方式,以提高诊治水平。方法回顾性分析20例外伤性小肠穿孔患儿的临床资料,包括临床症状、辅助检查、手术方式及诊治结果。结果患儿均有不同程度腹痛及腹膜炎体征,10例腹腔穿刺中,阳性8例(80%);10例腹部立位片检查中,5例见膈下游离气体(50%);17例B超检查中,10例有显著腹腔积液(5
2、8.8%);12例CT检查中,9例有异常(75%),均经手术治愈出院,其中3例出院后1月余出现粘连性肠梗阻,予保守治疗后痊愈出院,1例因乙状结肠造瘘术后再次入院行造瘘口回纳术,术后痊愈出院。结论小儿外伤性小肠穿孔多有腹痛、腹膜炎等临床特点,结合辅助检查有利于早期诊断,选择合适的手术方式是提高治愈率的关键。【关键词】外伤;肠穿孔/诊断;肠穿孔/治疗;儿童Analysisofdiagnosisandtreatmentoftraumaticsmallintestinalperforationinchildren(Reportof20cases).FENGShao
3、guang,CHENXiaoming.DepartmentofPediatricSurgery,TheSecondAffiliatedHospitalofWenzhouMedicalUniversity,Wenzhou325000,China【Abstract】ObjetiveToexploretheearlydiagnosisandtreatmentoftraumaticsmallintestinalperforationinchildreninordertoimprovethelevelofdiagnosisandtreatment.MethodsR
4、etrospectiveanalysiswasgiventotheclinicaldata(clinicalsymptoms,auxiliaryexamination,surgicalproceduresandtheresults)in20childrenwithtraumaticsmallintestinalperforation.ResultsAllthechildrenhaddifferentdegreesofabdominalpainandpositiveperitonealirritationsign,therewere8positivecase
5、samong10casesundergoingabdominalpuncture,accountingfor80%,5casesshowedsubdiaphragmaticfreeairin10casesundergoingXrayexamination,10casesshowedmarkedascitesin17casesundergoingBultrasonography,9casesshowedabnormalin12casesundergoingCTexamination.Allwerecuredbysurgicaloperation,thre
6、ecasesshowedadhesiveintestinalobstructionafterdischargingaboutonemonthwerecuredafterconservativetreatment.Onecasecamebacktohavecolostomyreversalsurgeryforpostoperationofsigmoidcolostomy.ConclusionMostofchildrenwithtraumaticsmallintestinalperforationhaveclinicalcharacteristicssuchas
7、abdominalpain,peritonitis,etc.Combinedwiththeauxiliaryexamination,itishelpfulfortheearlydiagnosis.Selecttheappropriateoperationmethodisthekeytoimprovethecurerate.【Keywords】Trauma;IntestinalPerforation/DI;IntestinalPerforation/TH;Child在小儿腹部外伤中,相比肝脾挫裂伤,空腔脏器损伤较少见,而在空腔脏器损伤中,又以小肠穿孔较资料与
8、方法多见,由于腹部外伤常合并多脏器损伤,部分患儿小肠
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