The Treatment Of Abdominal Injury With Severe Multiple Trauma

BackgroundWith the development of society, The number of severe multiple injuries causeby a variety of reasons such as accidents is increasing.Patients with mainly abdominaltrauma with severe multiple trauma often lost opportunities in the early course oftreatment due to severe hemorrhagic shock. Nowadays, separate emergency surgicalward is very few in China, so less relevant studies have been reported. Recent studiesshow that rational use the concept of damage control、fluid resuscitation、first aidgreen channel、the entire treatment system integrated in the treatment of severeabdominal trauma with multiple injuries have a better clinical effect.ObjectiveThis study was designed to summarize the treatment experience of merger severeabdominal trauma with multiple injuries in our hospital, to explore more effectiveemergency treatment scheme and improve the treatment level.MethodsClinical data of49patients of abdominal trauma with severe multiple traumapatients were retrospectively analyed from August2012to August2012in thedepartment of emergency surgery of First Affiliated Hospital of Bengbu MedicalCollege. Injury severity score (ISS) of the patients included in the study were greaterthan or equal to16. Rescue success rate、mortality were analyzed the emergencytreatment methods to assess the effect on patients and to summary emergencytreatment experience.Results37cases of male and female12in this group.male to female ratio was1.88:1. The average age is33.56±10.46years from13to72years. High incidence of agefrom20to40years old, accounting for87.8%. Traffic accidents as the first reason ofthe cases in injury, a total of39patients (79.6%), followed by high fall injury, a totalof4patients (8.2%), and the remaining6patients were injured by heavy objects(8.2%), knife stabbing2(4%). Major abdomen damage:26cases of splenic rupture,20cases of liver rupture,2cases of gastric rupture,3cases of pancreatic injury,4cases of kidney injury,1case of duodenal injury,5cases of small intestine rupture,4cases of rupture colonale.45case of Blunt abdominal injury and4case of openabdominal injury in all Abdominal injury,with17cases of hemorrhagic shock,1caseof septic shock consolidation and postoperative of cardiopulmonary resuscitation. Atotal of73site of injury, including: head9, face3, chest17, upper6, lower limb4,pelvic2，body surface32. Cured47cases (95.92%) and death2cases (4.08%) aftercomprehensive treatment of active recovery、surgical operation and non-surgicaloperation，1case died of severe hemorrhagic shock and1case died of severe braininjury。ConclusionThe abdominal injury with severe multiple trauma injuries are complex. We mustgrasp specific information of organ damage in patients，take “trauma emergency greenchannel” and “emergency special convenient channel”、implementation of earlytreatment，it is the key to improve the success rate of treatment and reduce the death.Implement the concept of damage control and fluid resuscitation can improve clinicalefficacy.