临床普外科电子杂志 ›› 2022, Vol. 10 ›› Issue (4): 41-.

• • 上一篇    下一篇

经皮腹腔穿刺置管引流在腹部闭合性损伤并脾挫裂伤诊疗中的应用体会

  

  1. 河池市人民医院 普通外科,广西 河池 547001
  • 出版日期:2022-10-01 发布日期:2023-01-13

Application of percutaneous abdominal puncture and drainage in the diagnosis and treatment of closed abdominal injury combined with splenic contusion and laceration

  1. General Surgery Department of Hechi People's Hospital, Guangxi Hechi 547001, China
  • Online:2022-10-01 Published:2023-01-13

摘要:

目的 探究经皮腹腔穿刺置管引流在腹部闭合性损伤合并脾挫裂伤诊疗中的应用效果。方法 选取2016 年1 月至2021 年6 月河池市人民医院收治的52 例腹部闭合性损伤合并脾挫裂伤患者,均经皮腹腔穿刺置管引流非手术治疗。回顾性分析患者的临床资料,统计患者临床诊疗结果、并发症发生情况与生活质量改善情况。结果 52 例腹部闭合性损伤并脾挫裂伤患者中,51 例患者穿刺结果为阳性,穿刺阳性率和准确率均为98.08%。1 例因穿刺并发症所致假阳性,穿刺并发症发生率为1.92%。所有患者均无非治疗性剖腹手术和死亡。其中,除1 例继发出血、1 例迟发肠道穿孔而中转开腹手术外,剩余50 例均经保守治疗痊愈出院,保守治疗成功率为96.15%。随访3 个月后,除1 例粘连性肠梗阻外,其余均未出现并发症。患者随访3 个月的生活质量评分明显高于出院前,差异有显著性(P < 0.05)。结论 经皮腹腔穿刺置管引流治疗腹部闭合性损伤合并脾挫裂伤,穿刺阳性率与诊断准确率较高,同时能减少穿刺并发症,提升患者保守治疗成功率,改善患者的生活质量。

关键词: 经皮腹腔穿刺置管引流, 腹部闭合性损伤, 脾挫裂伤, 应用, 效果

Abstract:

Objective To explore the effect of percutaneous abdominal puncture and drainage in the diagnosis and treatment of closed abdominal injury combined with splenic contusion and laceration. Method From January 2016 to June 2021, 52 patients with closed abdominal injury combined with splenic contusion and laceration admitted to Hechi People's Hospital were selected for non-surgical treatment through percutaneous abdominal puncture and drainage. The clinical data of the patients were analyzed retrospectively, and the clinical diagnosis and treatment results, complications and improvement of quality of life were counted. Result Among 52 patients with closed abdominal injury and splenic contusion and laceration, 51 patients had positive puncture results. The positive rate and accuracy of puncture were 98.08%. One case was false positive due to puncture complications. The

incidence of puncture complications was 1.92%. Moreover, none of the patients in this study had non therapeutic laparotomy and death. Among them, except for 1 case of secondary bleeding and 1 case of delayed intestinal perforation, the remaining 50 cases were cured and discharged after conservative treatment, and the success rate of conservative treatment was 96.15%. After 3 months of follow-up, there were no complications except 1 case of adhesive intestinal obstruction, and the quality of life score of the patients was significantly higher than that before discharge (P < 0.05). Conclusion Percutaneous abdominal puncture and catheter drainage for the treatment of abdominal closed injury combined with splenic contusion and laceration has a high positive rate of puncture and diagnostic accuracy. At the same time, it can reduce puncture complications, improve the success rate of

conservative treatment, and improve the quality of life of patients.

Key words: Percutaneous abdominal puncture and drainage, Closed abdominal injury, Splenic contusion and laceration, Application, Effect