67例闭合性肝损伤的诊断与治疗

Diagnosis and Treatment of Closed Hepatic Injuries——A Report of 67 Cases

对12年来67例闭合性肝损伤手术资料进行分析。结果80％为交通事故和坠落伤,77.6％为肝右叶损伤,56.7％伴有多发伤,50.7％伴有失血性休克。手术所见55例为中度损伤,8例为重度损伤,肝修补为主要术式。全组治愈58例,死亡9例。闭合性肝损伤由于伤情复杂,病情凶险,故早期明确诊断是提高其治愈率的前提,积极复苏、尽快探查、合理术式及充分引流是降低死亡率及提高治愈率的关键。

Sixty-seven cases of closed hepatic injuries were treated surgically in the past 12 years. And of them 56.7% had multiple injuries other than in the liver and 50.7% were accompanied with hemorrhagic shock. During the operation, 77.6% of the wounds were located in the right lobe of liver; moderate injuries were found in 55 cases and severe in the other 8. The main surgical technique was hepatic repair. After the operation 58 cases were cured and 9 died. The authors stressed on the importance of early diagnosis, abdominal centesis, appropriate resuscitation, timely exploration, rational technique and post-operative drainage.