外伤性肝脾破裂的非手术治疗

Non-operative Treatment of Traumatic Liver Rupture and Splenic Rupture

目的探讨外伤性肝脾破裂的非手术治疗的适应证和治疗方法。方法对1997年5月～2007年5月所收治的130例肝脾破裂中非手术治疗的47例从伤情、年龄、病例选择情况及治疗结果进行分析。结果47例(其中肝破裂18例)平均年龄34岁,年龄>60岁者4例。根据B超或CT评估肝脾破裂均为Ⅰ、Ⅱ级。无重大合并伤。43例非手术治愈,4例中转手术治愈,无并发症,平均住院16.5d。结论非手术治疗肝脾破裂具有可行性。重视B超或CT检查在外伤性肝脾破裂的非手术治疗中的作用,严格选择适应证,合理治疗及早期严密监测是提高非手术成功率的关键。

Objective To explore the indications and treating methods of non-operative treatment of traumatic hepatic rupture and splenic rupture. Methods Among the 130 cases of non-operative treatment of traumatic hepatic rupture and splenic rupture from May, 1997 to May, 2007,47 cases were analyzed from the aspects of injury conditions, ages, the selections of medical records and the treatment results. Results The mean age of 47 eases was 34 years（ 18 cases with traumatic hepatic rupture） and four cases were 60 years old. According to B-ultrasonic diagnosis and CT evaluation,the traumatic hepatic rupture and splenic rupture of these cases were among grade Ⅰ and grade Ⅱ without any severe combined injury. 43 cases were cured by non-operation treatment and four cases were cured by transferring to open operations without complications. The average hospitalization time was 16 days. Conclusion The feasibility of non-operative treatment of traumatic hepatic rupture and splenic rupture is positively approved. Importance should be attached to B-ultrasonic diagnosis and CT evaluation in non-operative treatment of traumatic hepatic rupture and splenic rupture. The strict selection of indications, proper treatments and the close monitoring in early stages are the key points to higher the successful rate.