摘要
目的 总结创伤性肝破裂的诊断、治疗的经验和教训。方法 分析我院收治的 1 2 0例创伤性肝破裂。结果 本组中 ,车祸伤 5 4例 ,刀刺伤 2 8例 ,坠摔伤 2 0例 ,其它 1 8例。单纯肝破裂 6 1例 ,合并其它脏器损伤者 5 9例。腹腔穿刺、B超和CT检查的诊断阳性率分别为 92 .3%、93.8%和 93.6 %。入院时休克 1 0 8例。术中发现腹腔内积血 30 0～ 35 0 0 ml,平均 1 35 0 ml。肝修补 75例 ,肝部分切除 33例 ,保守治疗 1 2例。全组治愈率 93.3% (1 1 2 / 1 2 0 )。结论 早期诊断是及时救治创伤性肝破裂的首要环节。出血性休克是创伤性肝破裂致死的主要原因 ,抢救的重点在于纠正出血性休克。严重肝损伤应当机立断进行手术治疗 ,根据伤情选择肝修补、肝修补加明胶海绵或大网膜填塞和肝脏部分切除 。
Objective To summary the experience in the diagnosis and treatment of traumatic hepatic rupture.Methods Clinicopathological data from 120 patients withtraumatic hepatic rupture were studied retrospectively.Result In the group,there were 54 traffic accident wounds,28 knife thorn wounds,20 downfallen wound,and 18 other wounds.61 cases had Simple hepatic rupture,59 cases were combined damage of the other internal organs.The accuracy rate of diagnosis was 92.3%,93.8% and 93.6% in the diagnostic peritoneal punctures,abdominal ultrasonography and CT respectively.When being hospitalized,108 cases were in shock.We discoveried abdominal cavity of patiensamass blood 300～3500ml,average1 350ml in operation.75 cases had repair of liver,33 cases part resection of liver,and 12 cases conservative treatment.The total cure rate was93.3%(112/120).Conclusions Early diagnosis is chief link that cure traumatichepatic rupture.Hemorrhagic shock after hepatic trauma is lethal major reason.The focal point of rescue lies in rectifier of hemorrhagic shock.Serious liver damage should carry out operatin treatment immediately.According to the condition of an injury,repairing hepatuic rupture purely,or filling gelatin sponge or greater omentum init simultaneously,or resecting part of liver is regular.Dissatisfactory hemostasis still need to add selectivity ligation of hepatic artery.
出处
《肝胆外科杂志》
2004年第3期183-185,共3页
Journal of Hepatobiliary Surgery
关键词
创伤
肝破裂
诊断
外科治疗
Trauma
Hepatic rupture
Diagnosis
Surgi cal treatment.
