间接暴力致肝门部放射状损伤

Diagnosis and therapy of radial rupture of porta hepatic due to blunt abdominal traum

目的 探讨腹部闭合性损伤致肝门部放射状肝破裂的形成机制、临床特点及治疗特点。方法 回顾性总结了 1990年 8月～ 2 0 0 2年 9月间 8例闭合性腹部外伤致肝门部放射状肝破裂及合并伤的临床表现、治疗方法和结果。结果 8例病人全部经手术治疗痊愈 ,对胆囊撕脱伤及胆管裂伤患者随访 2～ 3年 ,无不良反应。结论 肝门部放射状肝破裂由间接暴力所致 ,可伴有胆囊撕脱伤 ,肝门胆管、血管及第三肝门裂伤。主要表现为失血性休克 ,修补肝破裂的同时 ,注意合并伤的处理。

Objective To discuss the clinical and therapeutic characteritics of hepatic portal rupture due to blunt abdominal trauma. Methods The clinical manifestation, treatment and prognosis of 8 cases with radiate rupture in hepatic porta and associated injury due to blunt abdominal trauma were summarized retrospectively. Results All the eight patients were cured by surgical treatment. Four of eight patients developed cholecyst avulsion or bile duct laceration, and were followed-up for 2 to 3 years with favourable results. Conclusions Radial rupture of porta hepatic often results from indirect violence, and are sometimes accompanied with avulsion of cholecyst, laceration of bile duct or blood vessel of porta hepatic, even rupture of the third porta hepatic. Hemorrhagic shock is the principal feature. Much attention should be paid to the management of associated injury, as well as mending hepatic rupture.