87例严重肝外伤手术体会  

Analysis of surgical treatment of 87 cases major hepatic trauma

作　　者：谭友春[1] 卢榜裕[2] 范平[3] 张其顺[1] 陈延林[3] 

机构地区：[1]广西医科大学第四附属医院肝胆外科,广西柳州545005 [2]广西医科大学第一附属医院微创外科,广西南宁530021 [3]广西壮族自治区第二人民医院普外科,广西桂林541002

出　　处：《中国现代医学杂志》2005年第17期2638-2641,共4页China Journal of Modern Medicine

摘　　要：目的探讨提高外科治疗严重肝外伤的成功率的相应方法和措施。方法回顾性分析1985年1月～2004年10月收治的87例严重肝外伤的伤情、手术方法及效果。结果按AAST对肝脏损伤的分级,Ⅲ级外伤48例,Ⅳ级外伤25例,Ⅴ级外伤14例,腹腔内出血量600～2400mL,平均1700mL。手术治愈66例,死亡21例(失血性休克14例,复合伤、多脏器功能衰竭各5例,严重感染致ARDS2例)。结论正确而及时的诊断,减少术前时间,合理选择手术救治方法,是提高严重肝外伤治疗成功的关键。[Objective] To investigate the relevant approaches and measures on how to increase the successful rate of the surgical treatment in dealing with major hepatic trauma. [Method] To analyse the injuries, operation approaches and outcomes of 87 major hepatic trauma patients had been operated by us from January 1985 to october 2004 retrospectively. [Result] According to the AAST Gading of Liver Injuries, gradeⅢ 48 cases, grade Ⅳ 25 cases, grade Ⅴ 14 cases, the bleeding volume in the peritoneal cavity before operation were 600～2 400 mL, average 1 700 mL, 66 cases were cured, 21 cases died （14 cases of hemorrhage shock, 5 cases of combined wound and multiple organs failure, 2 cases of ARDS caused by severe infection）. [Conclusion] Precise and timely diagnosis, reduced preoperative time, reasonable surgical approaches were the keys to the success in the treatment of major hepatic trauma.

关 键 词：肝外伤 血 科手术治疗 

分 类 号：R657.3[医药卫生—外科学]