肝外伤的诊治(附70例报告)  

Diagnosis and Treatment of Hepatic Trauma(A Report of 70 Cases)

作　　者：谌班超 蒋新国[1] 喻新强[1] 夏拥军[1] 

机构地区：[1]湖南省安化县人民医院普外科,安化413500

出　　处：《中国现代手术学杂志》2006年第6期441-443,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的总结肝外伤的诊治经验。方法回顾性分析我院1996年1月至2005年12月收治的70例肝外伤的临床资料,根据AAST分级:Ⅰ级14例(20.0%),Ⅱ级32例(45.7%),Ⅲ级22例(31.4%),Ⅳ级2例(2.9%)。行非手术治疗18例,手术治疗52例,其中传统探查46例,腹腔镜治疗6例。结果本组治愈65例(92.9%),死亡5例(7.1%),因严重粉碎性肝损伤清创后肝切除,术后死于肝功能衰竭2例,死于失血性休克2例,因合并肝后腔静脉破裂术中死于循环衰竭1例。发生并发症14例(20.0%),其中右胸腔积液6例,肺部感染5例,膈下脓肿2例,胰漏1例,均经保守治疗痊愈。结论轻度肝外伤可选择非手术治疗,而严重肝外伤要积极手术治疗,术式应遵循个体化原则。Objective To explore the diagnosis and treatment of hepatic trauma. Methods The clinical data of 70 patients admitted from January 1996 to December 2005 were analyzed retrospectively. The trauma were classified as grade Ⅰ in 14 cases, grade Ⅱ in 32 cases, grade Ⅲ in 22 cases and grade Ⅳ in 2 cases. Surgical treatment were performed through conventional way in 46 cases and laparoscopic way in 6 cases. 18 cases received conservative treatment. Results 65 cases were cured and 5 cases died. Complications presented as pleural effusion in 6 cases, pulmonary infection in 5 cases, subphrenic abscess in 2 cases, pancreatic fistula in 1 case, which were all cured by conservative treatment. Conclusions Conservative treatment could be selected to mild hepatic trauma. Individualized treatment should be given in accordance with the classification of the trauma.

关 键 词：肝 创伤和损伤 

分 类 号：R657.3[医药卫生—外科学]