非手术治疗单纯肝损伤77例临床分析

Nonoperative treatment for simple hepatic injury:ananalysis or77 cases

作者在８２例肝损伤中选择单纯肝损伤７７例（９３．９％）行非手术疗法，并获得止血满意、顾利纠正休克，并发症显著减少的疗效。依据外伤史、腹腔穿刺内出血，Ｂ超扫描、内窥镜、ｘ线气腹造影和ＧＰＴ等确诊并判断损伤程度。Ⅰ°、Ⅱ°肝损伤适宜行非手术疗法；行快速扩容和回收腹腔积血自体回输、胃肠减压并灌服益气活血中药煎剂等疗法。因合并严重多发伤，于伤后３～４天并发呼吸衰竭、ＤＩＣ、ＡＲＤＳ和急性肺水肿共死亡３例（３．９％），治愈７４例（９６．１％）。

Abstract In this study,77 of 82 hepatic injury cases wereselected for conservative therapy. The hepatic injuriesin all these 77 cases were originally graded as type ⅠorType Ⅱ by reviewing the history of trauma,abdominalparacentesis, B-mode ultrasonograhy,peritpneoscopy,X- ray pneumoperitoneography and serum GPT mea-surement.Patients were all resuscitated bv fast volumeexpansion,blood transfusion recovered from intraab-dominal bleeding,nasogastric tube decompressionadded by chinese herbs,Three patients died of com-pound internal organ injuries,respiratory failure andDIC,the remaining 74(96.1%)were cured.