损伤控制性手术原则在严重肝外伤治疗中的应用  

Use of damage control surgery for major liver trauma

作　　者：卢昕[1] 张磊[2] 熊俊[2] 尚丹[2] 郑启昌[2] 

机构地区：[1]湖北省武汉市第一医院普通外科,湖北武汉430022 [2]华中科技大学同济医学院附属协和医院肝胆外科,湖北武汉430022

出　　处：《中国普通外科杂志》2012年第1期13-16,共4页China Journal of General Surgery

摘　　要：目的:探讨损伤控制性手术原则(DCS)在肝外伤治疗中的应用价值。方法:回顾性分析168例III级以上严重肝外伤患者临床资料,按是否实施损伤控制性手术原则分为两组,比较两组在平均手术时间、并发症、病死率以及住院时间方面的差异。结果:DCS组的住院时间长于一期手术对照组[(24.5±3.2)d vs.(16.4±4.1)d](P<0.05),但其平均手术时间、术后并发症发生率及病死率较对照组明显降低[(102±27)minvs.(224±35)min;26.3%vs.38.4%;15.8%vs.30.1%)](均P<0.05)。结论:损伤控制性手术原则在肝外伤治疗中对患者是有益的,可降低患者术后并发症及病死率。Objective： To assess the application value of the principle of damage control surgery （DCS） in treatment of liver trauma. Methods： The clinical data of 168 patients with major hepatic trauma greater than grade III were retrospectively analyzed, qlae patients were divided into two groups according had been applied or not, and then the differences in average operating time~ length of hospital stay between the two groups were compared. to whether the DCS principle complications, mortality and Results： The length of hospital stay of the D CS group was longer than that of the one-stage operation group [ （24.5±3.2） d vs. （16.4±4.1） d] （P〈0.05）, while the average operating time, postoperative complication incidence and mortality of the DCS group were significantly lower than those of the one-stage operation group[（102±27） min vs. （224±35）rain; 26.3% vs. 38.4%; 15.8% vs. 30.1%）] （all P〈0.05）. Conclusion： The DCS principle is beneficial for management of patients with hepatic trauma, because it can reduce postoperative complications and mortality.

关 键 词：肝/损伤 肝/外科学 损伤控制性手术 

分 类 号：R657.3[医药卫生—外科学]