肝外伤的非手术治疗(附66例报告)  

Non-operative management for liver trauma (a report of 66 cases)

作　　者：曾志良[1] 蔡祥梧 魏尚典[2] 

机构地区：[1]广东省深圳市宝安区人民医院普外科,广东深圳518101 [2]湖南省常德市第一人民医院普外科,湖南常德以415000

出　　处：《中国普通外科杂志》2001年第4期356-358,共3页China Journal of General Surgery

摘　　要：目的　探讨肝外伤非手术治疗的临床意义及适用证。方法　回顾性分析 1987年 12月～ 2 0 0 0年 12月收治的 6 6例肝外伤病例行非手术治疗的临床资料。结果　 6 6例肝外伤中属Ⅰ级者 38例 (5 7.6 % ) ,Ⅱ级 18例 (2 7.3 % ) ,Ⅲ级 10例 (15 .2 % )。治愈 6 4例(97.0 % ) ,包括并发大出血中转手术治愈 2例。死亡 2例 (3 .0 % ) ,死亡原因为合并重度脑外伤。并发肝脓肿 4例 (6 .1% ) ,均经非手术疗法治愈。结论　肝外伤行非手术治疗适应于Ⅰ ,Ⅱ级肝外伤及少部份Ⅲ级肝外伤。在各种监测方法中血流动力学监测尤为重要 ,B超监测有重要意义。非手术治疗中要注意并发症的处理 。Objective To investigate the clinical significance and indications of non operative management for liver trauma(LT). Methods The clinical date of 66 cases of LT treated by non operation from November 1987 to November 2000 were retrospectively analyzed. Results There were 38 cases (57.6%) in class I of LT, 18(27.3%) in class II, 10(15.2%) in class III in this series. 64 cases were cured (97.0%), including 2 cases combined with active bleeding were converted to operation and curred; 2 cases (3.0%) died of combining with severe brain damag. 4 cases(6.1%) complicated with liver abscess were cured by non operative treatment. Conclusions The non operative management is suitable for all cases of class I, II and partial cases of class III of LT. The observation of blood dynamics is most important, and B-type ultrasonography is also imporant, The operation would be done if the case is combined with massive active bleeding.

关 键 词：治疗 创伤 损伤 超声检查 肝外伤 

分 类 号：R657.305[医药卫生—外科学]