腹部损伤英文课件

AbdominalInjury腹部损伤英文课件腹部损伤英文课件腹部损伤英文课件theoutlinetheincidenceofabdominalinjuriesinpeacetime:0.4%-1.8%inwartime:50%themortalityofabdominalinjuriesis10%腹部损伤英文课件Typesoftheabdominalinjuriesabdominalinjuryopenabdominalinjuryclosedabdominalinjurypenetratingabdominalinjurynon-penetratingabdominalinjuryIatrogenicinjury腹部损伤英文课件腹部损伤英文课件MechanismofclosedinjuryDirectimpactDecelerationandrotationalforcesSpleen,kidney,smallbowelandliverarethemostcommonlyclosedabdominalinjuriedorgans.腹部损伤英文课件MechanismofopeninjuryStabwoundsGunshotwoundsLiver,smallbowel,stomachandcolonarecommonlyinvolvedintheopenabdominalinjuries.腹部损伤英文课件Theseverityoftheinjuriesandinvolvedorgansdependontheintensity,velocity,positionanddirectionoftheforce.Abdominalanatomicfeaturesandthefunctionsoftheorgansarealsoimportanttotheinjuries.腹部损伤英文课件clinicalmanifestationsabdominalpainhemorrhagicshockperitonitis腹部损伤英文课件abdominalorgansinjuriesaredividedtosolidandholloworgansinjuries.themainmanifestationofthesolidorgansinjuriesishemorrhagethatcanleadtoshock.themainmanifestationoftheholloworgansinjuriesisperitonitis.腹部损伤英文课件Hemorrhageandperitonitiscanexistsimultaneously,whentheinjuriesinvolvethe2kindsofabdominalorgans.腹部损伤英文课件DiagnosisAccuratediagnosisandmanagementrequiresathoroughhistory,physicalexamination,and,whenindicated,laboratorytests.腹部损伤英文课件whenwediagnosetheinjuryastheopenabdominalinjury,weshouldconsiderifthereisapenetratinginjury.腹部损伤英文课件DiagnosisoftheclosedabdominalinjuryDoestheabdominalorganinjuryexist?Whichorganisinjuried?whethermultipleorgansareinvolvedintheabdominalinjuries?腹部损伤英文课件whenit'sstilldifficultytodiagnose,thefollowingmeasurescanbetaken.auxiliaryexaminationdignosticabdominalparacentesisandperitonealLavagex-ray

UltrasoundAbdominalcomputedtomographyMRI,angiography,diagnosticlaparoscopy★腹部损伤英文课件★

observingclosely

①determinethepulserate,respiratoryrate,bloodpressureevery15-30minutes.

②examinetheabdominalsignsevery30minutes.③determinetheerythrocytenumber,hemoglobin,hematocritevery30-60minutes.腹部损伤英文课件★

exploratorylaparotomy

TheindicationsforlaparotomyAbdominalpainandperitonealirritationsignaggravategradually.Boweltonesbecomesmoreweaker,evendisappeared.Theerythrocytenumberandbloodpressureareinstability.GastrointestinalbleedingRefractoryshock腹部损伤英文课件ManagementoftheabdominalinjuryWeshouldidentifyandcorrectanyimmediatelife-threateningconditionsandtreatwith

theotheranticipateproblems.CPRisthemostimportantthinginthecriticalcase.△

A——Airway△

B——Breathing△

C——Circulationwithhaemorrhagecontrol腹部损伤英文课件Don'tsendtheexposedabdominalorgansbacktotheperitonealcavity.CoverthemwithwarmNSsoakedgauze.腹部损伤英文课件Antishocktherapyisakeystepinthetherapeuticprocedure.Ifgivenactiveantishocktherapy,theshockstilldifficultytocorrect,itsuggeststhatthereisprogressiveintraperitonealhemorrhage,theexploratorylaparotomyisnecessary.腹部损伤英文课件Inprinciple,thelaparotomyshouldexploretheabdominalorgansinorderasthefollowing:thesolidorgans→diaphragma→stomach→duodenum→jejunum→ileum→mesentery→pelvicorgans→posteriorsurfaceofstomach→panceas腹部损伤英文课件Splenicrupture腹部损伤英文课件腹部损伤英文课件腹部损伤英文课件Thespleenremainsthe

most

commonly

injuredorgan.inclosed

injury:20%~40%inopeninjury:10%腹部损伤英文课件TheMagnitudeofspleanicrupturedependonpatientage,injurymechanismandpresenceofunderlyingdisease.TheMagnitudeofspleanicrupturedependonpatientage,injurymechanismandpresenceofunderlyingdisease.腹部损伤英文课件

♣Nowspleenisrecognizedasanimportantimmunologicfactory.Theriskof

overwhelmingpostsplenctomyinfection(OPSI)isgreatestinchildlessthan2yrs.

♣RecognitionofOPSIhasstimulatedeffortsto

Conservespleen

bysplenorrhaphy.

腹部损伤英文课件TREATMENTInitialManagementNonoperativeapproach:

widelypracticedinpediatrictraumathecriteriafornonoperativeapproachOperativeapproach:Decisiontoperform

splenctomyor

splenorraphyisusuallymadeafterassessment&gradingthesplenicinjury.腹部损伤英文课件Contraindicationforsplenicsalvage:Thepatienthasprotracted hypotensionUnduedelayisanticipatedin

attempting

repairthespleenThepatienthasothersevereinjury腹部损伤英文课件Liverrupture腹部损伤英文课件腹部损伤英文课件腹部损伤英文课件Operativemanagement-liverGauzepackingmayhaveinfectivecomplications(IvaturyRRetal1986)OmentalpackingResectionaldebridementMassliversutureHepaticarteryligationTotalhepaticisolation-goodforretrohepaticvenousinjuriesAtriocavalshunt腹部损伤英文课件腹部损伤英文课件腹部损伤英文课件pancreaticinjury

腹部损伤英文课件Character♠acuteabdominalpainbecauseofthechemicalperitonitiscausedbypancreaticjuice♠AMYinthebloodandurine↑↑♠difficulttodiagnosebeforethelapartomy腹部损伤英文课件Treatment☀kposthesis☀partialexcisionanddrainage腹部损伤英文课件Gastricinjury腹部损伤英文课件Character♠Peritonitis♠pneumoperitoneumTreatment☀kposthesis☀excision腹部损伤英文课件Duodenalinjury腹部损伤英文课件Character♠notinjuriedeasily♠notnoticedeasily♠mostlysevere

Treatment☀kposthesis☀anastomosis☀decompressionanddrainage腹部损伤英文课件Smallintestinerupture腹部损伤英文课件Character♠highincidencerate♠Peritonitisisthemainmanifest.♠pneumoperitoneumTreatment☀Kposthesis☀Partialexcisionandanastomosis☀Thebloodvessel