肝外伤43例诊治分析

ANALYSIS OF 43 CASES OF LIVER TRAUMA ON DIAGNOSIS AND TREATMENT

目的：探讨肝外伤的早期诊断、术前复苏、非手术治疗适应症和手术止血方法选择。方法：对1988年7月至1999年1月间收治的43例肝外伤患者临床资料进行回顾性分析，并结合有关文献的复习。结果：43例肝外伤患者均作诊断性腹腔穿刺，结果阳性40例，阳性率93.02％。非手术治疗8例，均治愈；手术治疗35例，死亡3例。结论：腹腔穿刺阳性率高，是早期诊断肝外伤的重要手段。术前快速复苏是抢救严重失血性休克的重要步骤。非手术治疗肝外伤必须严格掌握适应症，手术止血方法的选择应根据具体损伤情况决定术式，对于严重肝外伤常需采用多种手术止血方法。

ObjectiveTo inquire into liver trauma ou early diagnosis, preoperative resuscitation, indications of non - operative treatment and operative hemostatic methods Methods 43 cases of liver trauma were hospitalized from July 1988 to January 1999 and their Clinical data were analyzed retrospectively. The Past relevant reference papers were also reviewed. Results Ai the 43 cases underwent abdominal paracentesises and 40 of them were positive (93.02 % ). 8 of the 43 as underwent mon-operative treatments and were all cured. The other 35 cases underwent operative treatments and 3 of them died. Conclusion The positive rate of abdominal paracentesis is high, and the paracenteis is a important methed to cliagnose the liver trauma. Rapid preoperative resuscitation is a important step to treat for the hemorrhagic shock. The non - operative indications of liver trauma must be controlled strictly. The operative hemostatic methods must be accordant with the conditions of live trauma. A series of operative hemostatic metheds usually are adopted to treat for severe live trauma.