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39例严重肝损伤的院内救治

Hospital treatment of 39 cases of severe liver injury

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【作者】 陈学云; 颜荣林; 杨兴易; 王来根; 郭闻渊; 王维东;

【Author】 CHEN Xueyun,YAN Ronglin,YANG Xingyi, et al. Dept. of General Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai 200003, China

【机构】 第二军医大学附属长征医院普通外科; 解放军急救医学中心; 上海东方医院创伤急救中心;

【摘要】 目的 探讨严重肝损伤院内救治的最佳措施。 方法 对39 例严重肝损伤患者的致伤原因、损伤程度、血压情况、合并伤、术前时间、手术方式、术后并发症及死亡率进行统计分析。结果 治愈32 例,死亡7 例,死亡率17.9 % 。主要死因为大失血和胸部合并伤。 结论 快速有效复苏、缩短术前时间、正确选择手术方式、积极处理合并伤,可提高救治成功率。以间歇性阻断肝蒂后行指捏法肝脏清创止血或清创性肝切除、大网膜或明胶海绵填塞缝合、创口或肝周纱布填塞加肝动脉结扎可作为救治严重肝损伤的主要方法。

【Abstract】 Objective To investigate the best hospital therapy for severe liver injury. Methods Statistical analysis was made on the clinical data of 39 patients with severe liver injury. The data included cause and degree of injury, blood pressure, associated injuries, preoperative time, operative pattern, postoperative complications and mortality rate. Results Thirty two patients were cured, 7 died; mortality rate was 17.9% . The leading cause of the death was significant blood loss and associated chest injury. Conclusions Rapid and effective resuscitation, shortened preoperative time, appropriate operative pattern and prompt management of the associated injury may win higher success rate. After intermittent occlusion of the hepatic pedicle, finger hepatic debridement hemostasis or hepatectomy, packing and suturing of omentum or gelatin sponge and gauze packing with hepatic artery ligation of wound or around liver can be the main methods for severe liver injury.

  • 【文献出处】 中华创伤杂志 ,CHINESE JOURNAL OF TRAUMATOLOGY , 编辑部邮箱 ,2000年02期
  • 【分类号】R657.3
  • 【被引频次】16
  • 【下载频次】27
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