填塞法在严重肝外伤中的应用(附13例报告)

Management of sever hepatic trauma with perihepatic packing (13 cases report)

目的 探讨肝周围填塞法在治疗严重肝外伤的应用价值。方法 回顾性分析 13例严重肝外伤病人的诊断和采用肝周围纱布填塞治疗。结果 13例肝严重肝外伤病人分别接受纱条或大纱布肝周围填塞。 7例在取出纱布后继发性出血而再次手术治疗 ,手术方式包括肝组织清除缝合术、肝动脉结扎术或肝叶切除术。术后有 2例出现肝周感染并发症。除 1例死于大出血外 ,其余 12例术后恢复良好。结论 纱布填塞这一古老的方法仍是治疗严重肝外伤一种重要而有效的辅助方法。在其它方法无效 ,而又不能耐受复杂操作的危急情况下确能起到争取时间、挽救生命的目的。

Objective To evaluate the intra-abdominal packing in treatment of sever hepatic trauma.Methods 13 cases with sever hepatic trauma categorized as Ⅲ and Ⅳ were studied retrospectively.Results 13 patients had packs inserted during a primary operative procedure, 7 of them, however, had a reexploration for secondary hemorrhage after removal of packs,and were further treated by surgical procedure, including debridement, hepatic artery ligation and lobotomy. Except for 2 patients complicated with perihepatic infection and one patient dying of copious bleeding all cases had a satisfactory results.Conclusion Temporary perihepatic packing can be life saving in patients with sever hepatic trauma.