近肝门肝外伤的治疗体会(附115例报告)

The treatment of hilar regional trauma with bile duct and vascular injury:A report of 115 cases

目的探讨近肝门肝外伤的外科处理方法。方法回顾性分析我们于1997年5月～2007年10月间收治的近肝门肝外伤115例的临床资料。结果本组术后发生再出血9例,再手术2例。感染6例,胆漏10例,胰漏2例。本组死亡16例,死亡率为13.91%。其中,术后死于失血性休克、凝血功能障碍和多脏器功能衰竭12例,因脑挫裂伤死亡4例。结论迅速控制入、出肝血流,合理处理肝内、外血管及胆管损伤,可减少并发症的发生,降低死亡率。

Objective To explore the surgical treatment of hilar regional trauma with bile duct and vascular injury. Methods The clinical data of 115 operative patients with hilar regional trauma from May 1997 to Oct. 2007 were retrospectively analyzed. Results Postoperative re-bleeding occurred in 9 cases and re-operation was done in 2 cases in this group. There were 6 cases of infection, 10 cases of cholerrhagia and 2 case of the pancreas leaks. Among 16 deaths in this group （13.91 %）, 12 cases died of hemorrhage shock, dysfunction of blood coagulation and multi-internal organs function failure,and 4 cases died of brain frustrates. Conclusion To control the liver blood stream rapidly,and process the damage of blood vessels and bile ducts of the liver reasonably could reduce the occurrence of complication and cut down the mortality rate in hilar regional trauma.