腹部闭合性损伤中肝脾破裂的非手术治疗  

Non-operative treatment of liver or spleen ruptures in abdominal close injuries

作　　者：杨致富[1] 顾德智[2] 葛旭明[2] 李锴[2] 许卫东[2] 

机构地区：[1]首都医科大学附属北京朝阳医院京西院区普外科,100043 [2]徐州医学院附属连云港医院普外科

出　　处：《中国急救复苏与灾害医学杂志》2007年第6期353-355,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨腹部闭合性损伤肝脾破裂非手术治疗的适应证及治疗措施。方法3年来14例腹部闭合性损伤肝脾破裂非手术治疗的临床资料。男11例,女3例。平均年龄39·5岁。肝破裂5例,脾破裂9例。结果14例患者中,4例肝破裂、8例脾破裂经非手术治疗痊愈,1例肝破裂、1例脾破裂转手术治疗。结论对伤情轻,血流动力学稳定的伤员非手术治疗是安全、经济的。血流动力学稳定是最重要的适应证,腹腔积血量、症状和体征可作为参考。Objective To investigate the indications and therapeutic measures of non-operative treatment of the liver and spleen rupture in abdomen closed injury.Methods Out of the 75 cases of abdominal close injury admitted to the Department of Emergency during 3 years 14 patients(18.67%) with liver or spleen rupture,11 males and 3 females,aged 39.5,including 5 cases of liver rupture(5/24) and 9 cases of spleen rupture(9/51),underwent non-surgical treatment.The non-surgical treatment measures included strict monitoring of life signs,life support such as transfusion of blood and crystalloid solution,anti-inflammatory treatment,absolute bed rest,gastrointestinal decompression,dynamical observation of peritoneal hematocele,etc.The clinical data of these 14 patients were analyzed retrospectively.Results Among the 14 cases,4 cases of liver rupture and 8 cases of spleen rupture were cured by the non-surgical treatment and 1 case of liver rupture and 1 case of spleen rupture were turned to operational treatment later and were cured at last.Conclusion Non-operative management of liver and spleen ruptures is safe and economic for the wounded with relatively mild wound condition and stable hemodynamics,and with the amount of peritoneal hematocele,symptoms and signs as reference.

关 键 词：肝脾破裂 非手术治疗 

分 类 号：R[医药卫生]