严重肝外伤的外科处理

SURGICAL TREATMENT OF SEVERE LIVER TRAUMA

本文总结近１０年来收治２４例严重肝外伤的外科处理情况。提出治疗关键是①早期诊断，积极抗休克，尽早剖腹探查。②充分暴露肝创面，尽量避免开胸。③根据肝脏损伤情况采取选择性肝动脉结扎，缝合修补加大网膜填塞，不规则肝叶切除；胆道减压及腹腔引流等多种手术措施。④重视合并伤的处理及术后保护重要脏器功能。

The article sums up a surgical treatment of 24 severe liver trauma in recent ten years and supplies the key points of the treatment for this kind of disease.①Early diagnosis,active anti-shock,exploratory laparotomy as early as it should be.②Fully explore the surface of the liver trauma,try to avoid opening thorax.③According to the hepatic injury,we can use several kind of operation systems such as proper ligation of hepatic artery,hepatorrhaphy and the greater omentum filling,the irregular liver lobectomy,the press reducing of the biliary tract as well as the intraperitoneal drainage.④Pay more attention in dealing with the compound injury and the protection on the main internal organ after operation.