损伤控制性手术在治疗严重肝外伤中的应用(附19例回顾性分析)

Application of damage control surgery to the treatment of severe liver injury-a retrospective analysis of 19 cases

目的探讨损伤控制性手术（DCS）在治疗严重肝外伤中的应用价值并总结手术经验。方法回顾性分析我院1999-01-2007-01间19例严重肝外伤患者应用损伤控制性手术治疗情况。结果19例患者均经损伤控制性手术治疗,其中痊愈15例,死亡4例。术后出现肝脓肿1例,胆瘘2例,膈下感染1例,消化道出血1例,均经保守治疗痊愈。结论符合DCS指征的严重肝外伤的患者,应积极实施DCS,提高综合治疗水平,根据损伤的不同部位和程度,分次手术治疗,可有效地降低严重肝外伤死亡率。

Objective To study the value of damage control surgery （DCS） in the treatment of severe liver injury and to sum up operative experience. Methods To retrospectively analyze 19 cases of severe liver injury with DCS treatment. Results 15 cases were cured, the rest died. After the operation, 5 cases including 1 with hepatic abscess, 1 subdiaphragmtic infection, 1 alimentary tract hemorrhage and 2 biliary fistula recovered with conservative therapy. Conclusion DCS should be performed in the patients of severe liver injury with the indication of DCS. The operation is done with multiple steps according to the sites and degrees of the injury, which could decrease mortality of severe liver injury effectively.