外伤性肝损伤的诊断和治疗(附83例报告)  

The Diagnosis and Treatment of Liver Injuries (Report of 83 Cases)

作　　者：金正明[1] 钱岳荣[1] 何健[1] 周鸿 

机构地区：[1]上海复旦大学医学院附属金山医院,上海200540

出　　处：《宁夏医学院学报》2001年第4期255-257,共3页Journal of Ningxia Medical College

摘　　要：目的 :探讨肝损伤手术与非手术的治疗方法。方法 :回顾分析 83例肝损伤的诊治经验。结果 :32例Ⅰ～Ⅱ级肝损伤行非手术治疗 ,30例保守成功 ,2例中转手术 ;5 3例手术治疗 ,死亡 6例 ( 1 1 3% ) ,1 8例Ⅳ、Ⅴ级严重肝损伤者死亡 3例( 1 6 7% )。结论 :肝损伤应根据伤情选择不同的治疗方法 ,单纯轻度肝损伤可采用非手术治疗 ;重症肝损伤抢救要点是及时有效止血 ,广义的肝清创术是减少术后并发症的有效措施。Objective:To evaluate the operative and non-operative management for the liver injuries.Methods:The diagnosis and treatment of 83 cases with liver injuries were analyzed retrospectively.Results:Thirty two cases with grade 1 and 2 injuries were treated conservatively.Among them,30 cases were cured,but 2 cases falied and finally operated.Fifty three cases were operated on,of which 6 cases died(11.3%).In 18 cases with grade Ⅳ and Ⅴ injuries,3 cases died(16.7%).The mortality was lower than that literature reported previously.Conclusion:The management of liver injuries should be individualized according to the severity.The moderate injuries should be attempted to treat non-operatively.The key to the management in the severe liver injuries is to control bleeding immediately and effectively.Sense-broad liver debridement is a effective means for decreasing postoperative complications.

关 键 词：外伤性肝损伤 非手术治疗 诊断 外科手术 

分 类 号：R657.32[医药卫生—外科学]