Đặc điểm lâm sàng, cận lâm sàng vỡ lách do chấn thương được phẫu thuật cắt lách tại Bệnh viện Quân y 103=Clinical and paraclinical characteristic of blunt splenic patients undergoing splenectomy at Military Hospital 103

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Chí Thanh Hồ, Bá Thành Lại, Hữu Văn Nguyễn, Mạnh Cường Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.25-31

Bộ sưu tập: Metadata

ID: 477743

Thêm vào giỏ

Splenic rupture is a common injury in blunt abdominal trauma, often in the setting of multiple trauma. Clinical and paraclinical evaluation is very important to have the attitude and to choose the treatment method urgently and appropriately for the patient. Aim: Study clinical and paraclinical characteristics of patients undergoing splenectomy due to trauma. Subjects and methods: A prospective and cross-sectional study on 65 of blunt splenic patients undergoing Splenectomy at Military Hospital 103 from January 2019 to June 2023. Results: 58 patients with traumatic splenic rupture undergoing Splenectomy, the mean age was: 30.6±13.049 years old, the youngest was 7 years old, and the oldest was 67 years old. Patients of working age were 87.9%, male ratio was 77.6%, and traffic accidents were 70.7%. There was 32.8% of isolated blunt splenic injury, 48.3% of the patients admitted to the hospital in shock, the rate of not receiving first aid before the hospital was 53.4%, and the average time to hospital was 4.2. ± 4.402 hours. 100% of the patients received an emergency ultrasound in bed, the rate of abdominal computed tomography with contrast injection was 58.6%, the splenic injury grade on CT was not related to shock with p >
0.05. Conclusion: Spleen ruptured abdominal trauma was common in working age. The common cause was traffic accidents, mostly multiple traumas, patients did not receive first aid before the hospital, and the shock rate was high.Vỡ lách là tổn thương hay gặp trong chấn thương bụng kín, thường nằm trong bệnh cảnh đa chấn thương. Đánh giá lâm sàng và cận lâm sàng là rất quan trọng để có thái độ, lựa chọn phương pháp điều trị khẩn trương và phù hợp với người bệnh. Mục tiêu: Đánh giá đặc điểm lâm sàng, cận lâm sàng bệnh nhân mổ cắt lách do chấn thương. Đối tượng, phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang hồi cứu kết hợp tiến cứu, 58 bệnh nhân chấn thương bụng kín vỡ lách được phẫu thuật cắt lách tại Bệnh viện Quân y 103 từ 1/2019 đến 6/2023. Kết quả: 58 bệnh nhân vỡ lách do chấn thương được phẫu thuật cắt lách, tuổi trung bình là: 30,6±13,049 tuổi, nhỏ nhất là 7 và lớn nhất là 67 tuổi. Bệnh nhân trong độ tuổi lao động là 87,9%. Tỉ lệ nam giới là 77,6%, do tai nạn giao thông là 70,7%. Vỡ lách đơn thuần là 32,8%, có 48,3% vào viện trong tình trạng sốc, tỷ lệ không được sơ cấp cứu trước viện là 53,4 %, thời gian được đưa đến bệnh viện trung bình là 4,2 ± 4,402 giờ. 100% bệnh nhân được siêu âm cấp cứu tại giường, tỷ lệ chụp cắt lớp vi tính ổ bụng có tiêm thuốc cản quang là 58,6%, phân độ tổn thương lách trên CT không liên quan đến tình trạng sốc với p >
0,05. Kết luận: Chấn thương bụng kín vỡ lách hay gặp ở lứa tuổi lao động, nguyên nhân thường gặp do tai nạn giao thông, phần lớn là đa chấn thương, bệnh nhân không được cấp cứu trước viện và tỷ lệ sốc cao.

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