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目的 探讨创伤性盆腔腹膜后血肿的诊断和治疗方法。方法 总结 1992～ 2 0 0 2年浙江省温岭市第一人民医院收治的 4 9例创伤性盆腔腹膜后血肿的临床资料。结果 单纯性盆腔腹膜后血肿 7例 ,合并其他脏器损伤 4 2例。腹穿阳性 4 4例 ,术前误诊为腹腔脏器损伤 10例。 3例做了血肿探查止血术。治愈 4 7例 ,死亡 2例。结论 仅依靠症状和体征很难鉴别单纯性腹膜后血肿及是否合并内脏损伤 ,CT检查能提高诊断率 ,腹腔穿刺阳性病人应结合CT检查综合考虑手术与否。单纯性盆腔腹膜后血肿稳定期不需切开探查。
Objective To investigate the diagnosis and treatment of traumatic pelvic retroperitoneal hematoma. Methods The clinical data of 49 cases of traumatic pelvic retroperitoneal hematoma admitted to First People’s Hospital of Wenling, Zhejiang Province from 1992 to 2002 were summarized. Results Simple pelvic retroperitoneal hematoma in 7 cases, combined with other organ damage in 42 cases. Abdominal perforation positive 4 4 cases, preoperative misdiagnosis of abdominal organ injury in 10 cases. 3 cases hematoma exploration hemostasis. 47 cases were cured and 2 died. Conclusion It is difficult to distinguish the simple retroperitoneal hematoma and the visceral injury by relying on the symptoms and signs only. The CT examination can improve the diagnosis rate. The patients with positive peritoneal puncture should be combined with CT examination to consider the operation or not. Simple pelvic retroperitoneal hematoma stable period without exploration.