CT在肝脏钝性损伤非手术治疗中的意义

Significance of computed tomography in the nonoperative management of hepatic blunt trauma

目的评价腹部CT在肝脏钝性损伤非手术治疗中的意义。方法回顾性分析我科近三年来收治的84例肝外伤非手术治疗患者的临床资料。结果本组患者均经腹部CT明确诊断。CT分级：Ⅰ级32例，Ⅱ级27例，Ⅲ级17例，Ⅳ级6例，Ⅴ级2例。非手术治疗期间行CT检查，发现胆痿、肝周脓肿各1例，延迟性出血2例，非手术治疗成功率为96．3％。结论CT是首选的肝脏损伤的检查方法；CT有助于辨别肝损伤的确切程度、定量分析腹腔积血量，还有助于对肝脏钝性损伤并发症的诊断；CT对于腹部其他脏器损伤的诊断及鉴别诊断亦有参考价值。

Objective To explore the significance of computed tomography in the nonoperative management of hepatic and splenic trauma. Methods Clinical data of 84 non - operative cases which were diagnosed as blunt liver injuries was collected. Results All patients were diagnosed by abdominal CT. According to CT grading, there were 32 cases in Ⅰ injuries, 27 in Ⅱ , 17 in Ⅲ ,6 in Ⅳ, 2 in Ⅴ. During the treatment, 1 case biliary fistula, 1 case perihepatic abscess and 2 cases delayed hemorrhage were found by CT. Success rate was 96.3%. Conclusions The CT scan remains the first choice for imaging hemodynamically stable blunt abdominal trauma and identifydegree of injury, amount of hematocelia quantitatively and complication diagnosis. CT also is valuable to diagnosis of other organ injuries.