肝外伤108例治疗分析

Clinical analysis of 108 cases of liver trauma

目的 :总结肝外伤的治疗经验。方法 :对 1 996年 1月～ 2 0 0 4年 1月收治的 1 0 8例肝外伤病例 (其中 级 1 4例 , 级 2 8例 , 级 4 2例 , 级 1 6例 , 级 8例 )进行回顾性分析。非手术治疗 32例 ;手术治疗 76例 (单纯肝组织缝补4 2例 ,不规则性、清创性肝切除 31例 ,碘仿纱布填塞 3例 )。结果 :本组治愈 99例 ,死亡 9例 ,与肝外伤相关并发症发生率为 1 6 .6 % (1 8/ 1 0 8)。结论 : 级以下损伤可适当保守治疗 , 级以上损伤应强化抗休克措施 ,依据损伤类型进行相应的手术治疗 ,以彻底清创止血 ,合理引流 。

Objective: To summarize the management experience of hepatic injury. Methods: The clinical data of 108 cases of hepatic injury (Grade Ⅰ, 14; Grade Ⅱ, 28; Grade Ⅲ, 42; Grade Ⅳ, 16; and Grade Ⅴ, 8) collected from January 1996 to January 2004 were analyzed retrospectively. Thirty-two patients received conservative treatment, and 76 accepted surgical treatment (simple repair, 42; irregular or debridement hepatectomy, 31; iodoform gauze packing, 3). Results: Ninety-nine cases were cured, and 9 died. The hepatic trauma-related complication rate was 16.6% (18/108). Conclusion: The patients with hepatic injury of less than Grade Ⅱ could be treated with the conservative therapy, but others should undergo anti-shock management as well as reasonably surgical treatment.