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目的:研究探讨基层医院对于小儿腹部闭合性损伤延误诊治所存在的问题以及相关应对解决措施,为基层医院医务工作者对于小儿腹部闭合性损伤患儿的处理措施,救治方式提供理论参考依据。方法:对我院2008年10月至2012年10月期间收治的60腹部发生闭合性损伤患儿,其中有延误诊治患儿13例。对于上述患儿的就诊情况,临床资料,病情发展进行回顾性分析,总结各方面延误小儿腹部闭合性损伤患儿诊治的原因,同时提出相应的解决措施。结果:发生不同程度的延误诊断患儿13例,占21.67%。本研究发现导致基层医院部闭合性损伤诊治存在拖延耽误的原因有:医务人员导致的诊治延误、患儿自身导致的诊治延误、患儿存在其他损伤掩盖了腹部症状、小儿腹部闭合性损伤患儿的伤情早期不明确。针对上述存在的问题应对措施有:医务人员应详细询问患儿病史、症状;对患儿进行详细的检查,包括腹腔穿刺等,并详细分析穿刺结果;同时重视利用有效的辅助检查,如X线、B超、CT等;必要时可以进行剖腹探查同时采取治疗措施;提高广大民众就医意识,发现问题尽早就诊,学会保护急救措施。结论:基层医院由于医疗设施、手段、医务人员的工作经验、水平等以及患儿自身原因等问题,会有小儿腹部闭合性损伤患儿的诊治收到延误的情况出现,容易造成不良后果,该现象应引起医务工作者的高度关注,积极采取措施,避免基层医院小儿腹部闭合性损伤延误诊治的情况出现。
OBJECTIVE: To study the problems existing in the delayed diagnosis and treatment of closed abdominal injury of children in primary hospitals and the corresponding countermeasures, and provide the theoretical reference for medical workers in primary hospitals for the treatment and treatment of children with closed abdominal injury. Methods: In our hospital from October 2008 to October 2012 were treated 60 cases of abdominal closure injury occurred in children, including 13 cases of delayed diagnosis and treatment of children. For the above-mentioned children’s treatment, clinical data, the development of the disease were retrospectively analyzed, summarize the causes of delayed diagnosis and treatment of children with closed abdominal injury in children, at the same time put forward corresponding solutions. Results: There were 13 cases of delayed diagnosis in different degree, accounting for 21.67%. This study found that the delay in the diagnosis and treatment of closed-circuit injuries in primary hospitals caused by delay in diagnosis and treatment caused by medical staff, diagnosis and treatment delay caused by children themselves, other injuries in children covered the abdominal symptoms, children with closed abdominal injury in children The early injury is not clear. In response to the existing problems, the following measures should be taken: Medical staff should ask their children’s medical history and symptoms in detail; carry out detailed examination on the children, including abdominal puncture, and analyze the puncture results in detail; meanwhile, pay attention to using effective auxiliary examinations such as X-ray , B ultrasound, CT, etc .; when necessary, laparotomy can be carried out while taking treatment measures; to improve the general public medical awareness and found that problems as soon as possible, learn to protect first aid measures. Conclusion: In primary hospitals, the diagnosis and treatment of infants with closed abdominal injury in children may be delayed in diagnosis and treatment due to the problems of medical facilities, means, medical staff’s working experience, level, etc., and their own causes, which may cause adverse consequences. The phenomenon should arouse the great attention of medical workers and actively take measures to prevent the delay diagnosis and treatment of closed abdominal injury in children in primary hospitals.