22例严重肝破裂的诊治体会  

Experience of 22 cases of diagnosis and treatment of severe liver rupture

作　　者：陈建荣[1,2] 陆孝道[1,2] 于进玲[1,2] 张学利[1,2] 

机构地区：[1]上海市奉贤区中心医院 [2]上海交通大学附属第六人民医院奉贤分院普外科,201400

出　　处：《重庆医学》2011年第16期1603-1604,共2页Chongqing medicine

摘　　要：目的探讨严重肝破裂的诊断和治疗方法。方法回顾性分析22例严重肝破裂患者的临床资料及诊疗措施。结果 22例严重肝破裂患者的主要症状是上腹痛,多伴休克,且合并腹膜刺激征,均经剖腹探查确诊。手术方法包括单纯缝合修补术(14例)、清创性肝切除术(6例)及纱布填塞止血法(2例)。存活20例(90.90%),死亡2例(9.10%)。发生术后并发症6例(27.27%),其中肠梗阻2例,肝内迟发性血肿2例,肝修补后再出血1例,膈下脓肿1例。结论尽早作出诊断并及时手术是治疗严重肝破裂的关键。Objective To discuss the diagnosis and treatment of severe liver rupture.Methods Clinical data and approaches to diagnosis and treatment of 22 patients with severe liver rupture were retrospectively analyzed.Results The primary symptom of 22 cases of severe liver rupture was abdominal pain,often accompanied by shock and peritoneal irritation sign.All of their diagnosis were confirmed by exploratory laparotomy surgical procedures conducted to patients included simple suture repair（14 cases）,debridement hepatectomy（6 cases） and gauze packing hemostasis（2 cases）.20 patients（90.90%） survived,2 patients（9.10%） died.Postoperative complications occurred in 6 patients（27.27%）,2 cases of intestinal obstruction,2 cases of intrahepatic delayed hematoma,1 case of rehemorrhage after liver repair surgery and 1 case of subphrenic abscess.Conclusion The key points of treatment of severe liver rupture are early diagnosis and timely surgery.

关 键 词：腹部损伤 诊断 肝切除术 出血 肝破裂 

分 类 号：R657.3[医药卫生—外科学]