创伤性肝破裂的早期诊断与手术治疗

Traumatic rupture of the liver in the early diagnosis and treatment

目的探讨创伤性肝破裂救治的最佳时机与治疗措施。方法回顾性分析1990/01～2006/12收治创伤性肝破裂56例的临床资料,按照治疗方法与手术时机将病人分为三组:A组:2例,为非手术治疗组;B组:29例,为创伤后6h内明确诊断手术治疗组;C组:25例,为创伤6h后明确诊断手术治疗组。将三组病人的死亡率,经统计学处理进行对比分析。结果A组无死亡,治愈出院;B组死亡3例,均死于失血性休克,2例并发胆汁性腹膜炎,经引流后治愈出院;C组死亡7例,其中5例死于失血性休克,2例死于胆汁性腹膜炎合并中毒性休克。结论手术是治疗创伤性肝破裂的首选方法,早期明确诊断,术中选择正确的手术方式是提高创伤性肝破裂疗效的关键。

Objective To explore traumatic rupture of the liver where the best opportunity and treatment measures. Methods A retrospective analysis 1990/01-2006/12 treated traumatic mopture of the liver in 56 cases of clinical data. According to the treatment method and timing of surgery patients will be divided into three groups： Group A： 2 cases, non-surgical treatment of group; group B： 29 cases, After the trauma of the six-hour period surgery for the diagnosis of group; group C： 25 to 6 hours after trauma diagnosis treatment group. Group 3 will be the mortality rate of patients was statistically analyzed and compared. Results Group A No deaths and patients discharged, group B 3 patients died, died of hemorrhagic shock, two cases with bile peritonitis. After drainage patients discharged after. Group C 7 died, five of whom died of hemorrhagic shock, Two patients died of bile peritonitis with toxic shock. Conclusions surgery is the treatment of traumatic rupture of the liver preferred method for early diagnosis, Intraoperative choose the correct procedure is to enhance hepatic injury prognosis.