外伤性肝脏损伤53例诊断与治疗分析

    Diagnosis and treatment of hepatic injuries: A report of 53 cases

    • 摘要: 目的: 探讨外伤性肝脏损伤(肝损伤)的诊断及治疗方法的选择。方法: 对53例肝损伤相关资料进行回顾性分析。结果: 53例肝损伤患者,Ⅰ~Ⅱ级46例,Ⅲ~Ⅳ级7例。非手术治疗16例,手术治疗37例。治愈51例,病死2例。结论: 腹腔穿刺、B超或CT检查对肝损伤有较好的诊断作用,对血流动力学稳定的Ⅰ~Ⅱ级肝损伤患者可试行非手术治疗。明胶海绵填塞后缝合修补+腹腔引流为Ⅰ~Ⅲ级肝损伤的理想治疗方法,选择性肝动脉结扎术及不规则性肝部分切除术可选用于Ⅲ~Ⅳ级肝损伤患者。

       

      Abstract: Objective: To discuss how to diagnose hepatic injuries and determine the way of therapy.Methods: Clinical data from 53 patients with hepatic trauma were analyzed retrospectively.Results: Among 53 cases,grade Ⅰto Ⅱ were 46 cases,grade Ⅲ to Ⅳ 7 cases.Sixteen cases were treated by nonoperative method,another 37 cases were operated.Out of all cases 51 were cured and 2 died.Conclusions: Abdominocentesis,B mode ultrasound or CT has a good diagnostic effect on liver damage.Nonoperative treatment could be used in hemodynamic steady patients.Suturation after glutin sponge tamponade plus peritoneal cavity drainage were ideal theraptic methods to grade Ⅰ to Ⅲ cases,while partial liver lobectomy and selective ligation of hepatic artery could be chosen for grade Ⅲ to Ⅳ cases.

       

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