2例腹部刀刺伤后合并腹腔高压综合征的急救与分析

2016-02-13徐冠胜

浙江医学教育 2016年1期

关键词：功能手术

徐冠胜

(天台县平桥医院，浙江天台 317200)

·基础与临床研究·

2例腹部刀刺伤后合并腹腔高压综合征的急救与分析

徐冠胜

(天台县平桥医院，浙江天台 317200)

目的：探讨腹部刀刺伤合并腹腔高压综合征(ACS)的急救方法。方法回顾性分析2例腹部刀刺伤伴失血性休克并发ACS病例，根据临床表现确定ACS诊断后立即行腹腔减压，扩大手术切口或暴露部分肠管均可达到减压目的。结果及时认识治疗ACS行腹腔减压适当扩大手术切口或暴露部分肠管，结果满意，病患恢复平稳。结论临床上出现了ACS相关症状时及时想到ACS和及时进行急救非常重要，术中仔细探查腹腔脏器,避免漏诊、漏治，是腹部刀刺伤的诊治关键。

腹部；创伤和损伤；腹腔高压综合征；腹腔减压；急救

Abstract：[Objective] Discussion with the diagnostic emergency treatment of abdominal stab wound with abdominal compartment syndrome (Abdominal compartment syndrome，ACS). [Method] Retrospective analysis of 2 cases of abdominal knife stabbed with hemorrhagic shock cases that complicated with ACS. Once the diagnosis of AGS according to the clinical manifestations, abdominal decompression, the appropriate expand of wound or the exposure of the part of the bowel should immediately done to achieve the relief of abdominal pressure. [Result] Know and treatment with ACS in time which expanding the wound or expounding?the part of the bowel with patients，the Patients have a satisfactory result and recovery smoothly. [Conclusion]In the clinical, when there comes with the ACS related symptoms, It is important to realize the ACS and give first aid immediately. In the operation, attaches great importance to the abdominal viscera, avoid misdiagnosis, leakage, is a key to the diagnosis and treatment of abdominal knife.

Keywords: the abdomen; wounds and injuries; abdominal compartment syndrome; abdominal decompression; first aid

腹腔内出血、急性胰腺炎、腹腔长时间复杂手术后未能有效引流等引发腹内压进行性急剧升高，进而导致的器官功能不全称之为腹腔高压综合征[1](Abdominal compartment syndrome，ACS)，但临床医师往往对其认识不足，常误诊为多器官功能不全(multiple systemic organ failure，MOSF)或其他病变，在一定程度上错失了对原发病的早期治疗时机[2]。腹部刀刺伤多由暴力事件引起，因系开放性损伤，诊断一般不难。笔者报告2例腹部刀刺伤合并ACS病例的急救过程，旨在为临床提供参考。