ABSTRACT
Objective? To?explore?the?clinical?effect?of?laparoscopic?exploration?in?the?diagnosis?and?treatment?of?abdominal?open?trauma.? Methods? Patients?with?abdominal?open?trauma?admitted?to?the?First?Affiliated?Hospital?of?Dalian?Medical?University?from?August?to?December?in?2018?were?enrolled.?According?to?different?exploration?methods,?11?patients?undergoing?laparoscopic?exploration?were?grouped?into?laparoscopy?group?and?20?patients?undergoing?exploratory?laparotomy?were?grouped?into?laparotomy?group.?The?operation?time,?the?length?of?hospital?stay,?cases?without?abdominal?visceral?injury,?postoperative?exhaustion?time,?cases?with?complications?and?incision?length?were?compared?between?the?two?groups.? Results? All?the?31?patients?were?experienced?with?knife?stab?wound,?with?26?males?and??5?females,?and?the?age?was?(33.39±11.47)?years?old.?Compared?with?the?laparotomy?group,?the?length?of?hospital?stay?was?significantly?shorted?in?the?laparoscopy?group?(days:?6.64±2.94?vs.?11.65±5.62),?the?postoperative?exhaustion?time?was?significantly?decreased?(hours:?40.36±29.04?vs.?75.60±42.84),?the?cases?with?complication?was?significantly?decreased?(case:?1?vs.?9),?the?incision?length?was?significantly?shorted?(cm:?5.50±5.14?vs.?16.95±5.28),??all?of?which?results?had?statistical?significance?(all?P?<?0.05).?The?operation?time?of?laparoscopy?group?was?shorter?than?that?of?laparotomy?group?(hours:?2.18±0.87?vs.?2.61?±1.28),?but?without?significant?difference?(P?>?0.05).?Confirmed?by?surgical?exploration,?5?patients?had?no?abdominal?visceral?injury,?with?3?in?the?laparoscopy?group?and?2?in?the?laparotomy?group,?and?the?result?had?no?significant?difference?between?the?two?groups?(P?>?0.05).? Conclusion? For?patients?with?abdominal?open?trauma,?laparoscopic?exploration?is?helpful?for?diagnosis?as?quickly?as?possible,?with?less?trauma?and?reduction?of?complications?incidence,?and?is?conducive?to?postoperative?rehabilitation.
ABSTRACT
OBJECTIVE To explore the risk factors of gas gangrene after open trauma for its early diagnosis and precaution.METHODS The data of 42 patients with gas gangrene after open trauma from Aug 2003 to Aug 2008,were collected.The risk factors of gas gangrene after open trauma had been retrospectively analyzed from the cause of the injuries,the distribution of latent period,wound,systemic symptoms,laboratory examination and treatment.RESULTS Gas gangrene after injury was related with open wounds for various reasons.Latent period of gas gangrene was 24-72 h.Early risk factors of gas gangrene among them mainly included degloved or avulsed skin-injury(100%),musce trauma(100.00%),contaminated wound and retained foreign bodies(95.24%),weak pulse of peripheral artery(95.24%),nervous injury(90.48%),and lower temperature of skin aound the wound(83.33%).There were obviously systemic symptoms in infective stage but in early stage were not.CONCLUSIONS Gas gangrene is extremely rare in injury patients but it is life-threatening.So more attention should be paid to the risk factors in order to decrease the incidence of gas gangrene after trauma.Improving the prognosis of patients;the wounded locations should be effectively treated early so as to improve the prognosis.