Tratamiento quirúrgico del trauma abdominal en pacientes atendidos en el Servicio de Trauma del Hospital Alcívar, período 2016-2017
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
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El objetivo del estudio fue analizar el tratamiento quirúrgico del trauma abdominal, mediante una investigación de campo en pacientes del Hospital Alcívar, Guayaquil, en el año 2016 y 2017. El estudio fue de tipo cuantitativo, observacional, retrospectivo, descriptivo y trasversal que incluye a 222 pacientes. Se empleó el programa SPSS 21 para el análisis de los resultados.Del total de pacientes del estudio (222), el 41,4% (92%) estuvo representado por el grupo etario entre 18-40 años que corresponde a los adultos jóvenes, el 62,6% (139) estuvo representado por el sexo masculino, residentes de zonas urbano-periféricas (54%) y rurales (20%) de procedencia la provincia del Guayas (85%). Del total de traumatismos cerrados, el 51% fue de víscera y del total de traumatismos abiertos, el 32% fue penetrante. La principal etiología del traumatismo abdominal fueron los accidentes de tránsito (37,4%), siendo la lesión asociada de las extremidades (51,8%) las más comunes. Las manifestaciones clínicas más frecuentes en el total de pacientes analizados fueron el dolor (100%), la distensión abdominal (80%) y los hematomas de la pared abdominal (70%). El Eco FAST con el 95,5% (212) fue el principal método diagnóstico del traumatismo abdominal, apoyado con la tomografía axial computarizada (TAC) en el 73%. Las lesiones de órganos intraabdominales más frecuentes fueron del hígado (50,9%), intestinos (29,9%) y el bazo (24,3%), donde la laparotomía exploratoria (56,8%) y la rafia primaria (24,3%) fueron los procedimientos más realizados. La evolución clínica del 81,5% (181) fue favorable y el índice de mortalidad durante el periodo de estudio fue del 10,8%. Se concluye que el traumatismo abdominal en el Hospital Alcívar es exitoso porque sigue los lineamientos terapéuticos del MSP y de protocolos internacionales para reducir la morbimortalidad.
Palabras claves: tratamiento, dolor, víscera.
IX
“SURGICAL TREATMENT OF ABDOMINAL TRAUMA IN PATIENTS ATTENDED AT THE TRAUMA SERVICE OF THE ALCIVAR HOSPITAL, PERIOD 2016-2017"
Author: Libia Isabel Zambrano Paredes.
Tutor: Eduardo Antonio Rivas Torres
The objective of the study was to analyze the surgical treatment of abdominal trauma, through a field investigation in patients of the Hospital Alcívar, Guayaquil, in 2016 and 2017. The study was of quantitative, observational, retrospective, descriptive and cross-sectional type that includes 222 patients. The SPSS 21 program was used to analyze the results. Of the total patients in the study (222), 41.4% (92%) was represented by the age group between 18-40 years that corresponds to young adults, 62.6% (139) was represented by sex male, residents of urban-peripheral (54%) and rural (20%) areas of origin in the province of Guayas (85%). Of the total number of traumatisms closed, 51% were visceral and of the total of open traumas, 32% were penetrating. The main etiology of abdominal trauma was traffic accidents (37.4%), with the associated lesion of the extremities (51.8%) being the most common. The most frequent clinical manifestations in the total of patients analyzed were pain (100%), abdominal distension (80%) and hematomas of the abdominal wall (70%). The FAST Eco with 95.5% (212) was the main diagnostic method of abdominal trauma, supported by computerized axial tomography (CAT) in 73%. The most frequent intraabdominal organ injuries were liver (50.9%), intestines (29.9%) and spleen (24.3%), where exploratory laparotomy (56.8%) and primary raffia (24 , 3%) were the most performed procedures. The clinical evolution of 81.5% (181) was favorable. and the mortality rate during the study period was 10.8%. It is concluded that the abdominal trauma at Hospital Alcívar is successful because it follows the therapeutic guidelines of the MSP and international protocols to reduce morbidity and mortality.
The objective of the study was to analyze the surgical treatment of abdominal trauma, through a field investigation in patients of the Hospital Alcívar, Guayaquil, in 2016 and 2017. The study was of quantitative, observational, retrospective, descriptive and cross-sectional type that includes 222 patients. The SPSS 21 program was used to analyze the results. Of the total patients in the study (222), 41.4% (92%) was represented by the age group between 18-40 years that corresponds to young adults, 62.6% (139) was represented by sex male, residents of urban-peripheral (54%) and rural (20%) areas of origin in the province of Guayas (85%). Of the total number of traumatisms closed, 51% were visceral and of the total of open traumas, 32% were penetrating. The main etiology of abdominal trauma was traffic accidents (37.4%), with the associated lesion of the extremities (51.8%) being the most common. The most frequent clinical manifestations in the total of patients analyzed were pain (100%), abdominal distension (80%) and hematomas of the abdominal wall (70%). The FAST Eco with 95.5% (212) was the main diagnostic method of abdominal trauma, supported by computerized axial tomography (CAT) in 73%. The most frequent intraabdominal organ injuries were liver (50.9%), intestines (29.9%) and spleen (24.3%), where exploratory laparotomy (56.8%) and primary raffia (24 , 3%) were the most performed procedures. The clinical evolution of 81.5% (181) was favorable. and the mortality rate during the study period was 10.8%. It is concluded that the abdominal trauma at Hospital Alcívar is successful because it follows the therapeutic guidelines of the MSP and international protocols to reduce morbidity and mortality.
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Trauma abdominal, Tratamiento quirúrgico, Dolor abdominal, Hospital Alcívar, Cantón Guayaquil, Ecuador, Estudios retrospectivos