创伤性肝脏损伤的临床治疗  

作　　者：冯仕彦[1] 冯燮林[2] 

机构地区：[1]四川省医学科学院.四川省人民医院急救中心,四川成都610072 [2]四川省第二人民医院,四川成都610061

出　　处：《医学信息（中旬刊）》2011年第7期2891-2892,共2页Medical Information Operations Sciences Fascicule

摘　　要：目的:探讨肝脏损伤的临床治疗选择。方法:回顾分析2008年5月-2010年5月收治的186例肝脏损伤患者的相关资料及治疗情况。结果:186例患者171例治愈,治愈率91%死亡15例。37例保守治疗患者中有2例中转开腹手术。手术治疗149例,主要手术方式为行单纯缝合修补、大网膜填塞修补清创加肝脏不规则性肝切除、规则性肝切除及选择性肝动脉结扎。结论:AAST损伤分级Ⅰ～Ⅱ级闭合性肝脏损伤患者及部分Ⅲ级患者血流动力学稳定,可采用保守治疗。Ⅲ～Ⅴ级患者以手术治疗为主。Objective：To investigate the clinical choices of liver trauma. Methods：The data of 186 patients managed in our hospital from May 2008 to May 2010 were analysed retrospectively. The severity of liver trauma was classified according to the1994 revised Organ Injury Sealing Committee of American Association for the Surgery of Trauma （AAST）. Results：One hundred seventy one patients were cured, among them,37 patients with stable hemodynamics were treated conservatively,of which 2 patients were converted into operation;One hundred forty nine patients were treated with operation. The main modes of operation were：simple suturation, pedicu- lated tamponment of greater omentum, debridement with ruptured anatomic or nonanatomic liver resection, selective ligature of branch of hepatic after. Condttsion： Patients with liver trauma in grade Ⅰ - Ⅱ can mostly be managed with conservative（nonoperative） treatments,but to the patients in grade Ⅲ - Ⅴ and patients with other organ injuries, or patients with unstable hemodynamics, surgical operations were adopted.

关 键 词：肝脏损伤 AAST损伤分级 保守治疗 

分 类 号：R657.3[医药卫生—外科学]