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Diagnosis and treatment of blunt abdominal trauma


Police to make a diagnosis as early as possible. (2) The other part of a serious abdominal injury, such as traumatic brain injury to cover up the abdominal symptoms and signs. Diverted the attention of the abdomen between doctors and patients. (3) the subjective factors on the injury of health care close observation, however subtle points depend on special test results, or wait for chances and so there is delay in diagnosis can result in the loss of the best timing of surgery. 1 patient died in our hospital is like that. A profound lesson. 2.3 The principle of treatment of blunt abdominal injury: The key is early diagnosis and treatment, control probe indication. Once the decision to surgery, preoperative preparation as soon as possible: the establishment of patency of the infusion channel. Cross-matching of blood. Nasogastric tube and Foley catheter placement. Any shock, fast input should be the first saline or Ringer lactate solution, reasonable and effective blood volume supplement to correct shock. For surgical exploration. Can reduce mortality and complications. I21 cut choice: not only to ensure a thorough exploration of the needs of all parts of the abdominal cavity, and can quickly cut and stitch. Often choose the middle cut i21, into the abdomen rapidly, less blood loss, can be extended to the bottom. When there is intra-abdominal bleeding, abdominal hemorrhage immediately after the suction to remove blood clots. Quickly identify the source of bleeding. Control. Clot that is generally concentrated at the site of bleeding. If no intra-abdominal bleeding, then the system should detect abdominal viscera. Peritoneal incision as seen when food residues, the first exploration of upper digestive tract,[link widoczny dla zalogowanych], the first probe to see the stool under the digestive tract. Exploration of bile duct and duodenum to see, if necessary,[link widoczny dla zalogowanych], cut the side of the peritoneum for exploration. Found rupture repair. System check and then other organs. Finally, as the case may be. Serious pollution should be repeated peritoneal washing, indwelling drainage tube. 2.4 The problem of intra-abdominal organ injury in surgery: surgical option except under the patient's general condition, with or without associated injuries, hospital conditions, technical strength and experience, comprehensive blood and other considerations. Also be the site according to visceral injury, degree, extent, cause of injury and other circumstances of the decision, and sometimes several surgical procedures to be adopted at the same time flexible. Spleen in blunt abdominal injury most common, Professor Xia Suisheng say: rupture of an emergency rescue operation in a critical condition, the success or failure of the surgical decision-making among the tilting moment, the most important principles of treatment should be Second. Spleen-preserving surgery can not be overemphasized, without prejudice to the premise of life, before considering preserving spleen of children and young people in post-splenectomy splenic tissue can be autologous transplantation. To prevent postoperative immune function. Suture deep liver rupture avoid dead space left over. Serious damage can be irregular depending on the circumstances of liver resection. Intestinal damage selection based on location and extent of damage repair or excision, anastomosis. Colon injury according to injury site, the degree of pollution,[link widoczny dla zalogowanych], combined injuries to general condition for possible surgery for bowel preparation directly after a match. Traumatic retroperitoneal hematoma, and more to our hospital due to pelvic fracture, do not require duct exploration. Good outcome of conservative treatment. Received :2006-10-17CR in the diagnosis of nasal trauma of Dingze. Sun Yuquan (General Hospital of Anshan Iron and Steel, Anshan, Liaoning 114000) Due to the volume of the nasal bone less, according to general photography photos, image size and structure of the nasal bone is unclear, the diagnostic accuracy of nasal bone fractures. Using computer X-ray photography (Computerradiology, CR) projection nose with excellent results. 1 use the equipment Shimadzu lid150G1250mAX ray machine. Laser Scanner Konica REGIUS150 and REGIUS --- IM image post-processing workstation for Laser Medicine Konica DRYPE0752 camera. 2 How-prone patients with stage photography,[link widoczny dla zalogowanych], head tilt, sagittal plane parallel to the table, such as the lateral skull. IP imaging plate with a 8x10-inch (plus cover line tube) placed in the outer cheekbones, bridge of the nose at the next 1cm of II 'center of the plate,[link widoczny dla zalogowanych], the vertical center line of the table by the bridge of the nose and nasal bone under 1cm tangent to shoot people at the center. After the exposure II 'board by the laser scanner for image acquisition, and then send the image to the image post-processing workstation for image processing, the image using the adjusted (negative image method) to save, print. 3 Results 3.1 The use of CR photography and image post-processing technology advantages significantly improve picture clarity and contrast, to provide a more accurate diagnosis images. 3.2 As the density and contrast adjustable, the use of technology to bridge of the nose and the negative image of small nasal bone fracture, fracture fractures, especially the thin-shaped fractures can clearly see short spikes, resulting in improved diagnostic accuracy. 3.3 CR photography, because there are advantages of image post-processing techniques so that exposure within a certain range to adapt to compensation. But the photographic exposure conditions or thick according to the patient and lesion characteristics of the body a reasonable choice, it should not rely on image post-processing techniques. Received :2006-1l-06
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