【摘要】 目的总结合并右肝静脉主干根部损伤的中央型肝外伤的救治体会。方法回顾性分析3例伴有右肝静脉主干根部损伤的中央型肝外伤患者的全部临床资料及随访资料。结果 3例患者的手术均获得成功;2例术后无并发症发生,1例术后先后并发脑水肿、成人呼吸窘迫综合征、心功能衰竭、肝肾功能损害及急性胰腺炎、肠麻痹、电解质紊乱;3例分别分别于术后17天、23天、37天康复出院;术后随访5年:3例全部恢复正常工作,其中2例右肝静脉主干修补者,1例血管通畅、肝功能完全正常,另1例血管轻度狭窄、肝功能轻度异常(此例同时合并有HBV感染)。结论伴有右肝静脉主干根部损伤的中央型肝外伤的救治仍较复杂和困难,具体手术处理措施应根据外伤类型、肝脏损伤范围及程度、右肝静脉损伤情况等因素综合决定,损伤的右肝静脉可予以修补,亦可予以缝扎。更多还原

【Abstract】 Objective To summarize the experience of rescue in the central type liver trauma associated with the root injury of right hepatic vein.Methods The clinical data of three cases with central type liver trauma with the root injury of right hepatic vein were analyzed retrospectively.Results The operations of three patients were successful.There was no postoperative complication in 2 cases.Postoperative complications,such as encephaledema,adult respiratory distress syndrome,heart failure,renal function damaged,acute pancreatitis,enteroplegia,and electrolytes disturbance occurred orderly after operation in one case.Three patients were discharged from hospital on 17,23 and 37 days after operation respectively.Postoperative follow-up of 5 years: all three patients were returned to normal.Among them,two cases of the right hepatic vein were repaired,1 case was vascular patency and liver functions were completely normal.The other one occured vascular mild stenosis and mildly abnormal liver function(This patient was combined with HBV infection).Conclusion The treatment for central type liver trauma associated with the root injury of right hepatic vein is more complex and difficult.Specific treatment should be based synthetically on the type degree,range of liver damage and the condition of right hepatic vein injury.The injured right hepatic vein can be repaired,also be received to ligation.更多还原