肝外伤术后大出血再手术治疗18例分析

Surgical therapy for post-operative intraabdominal hemorrhage in patients with severe liver trauma:a report of 18 cases

目的:总结肝外伤术后大出血再手术治疗的临床疗效和经验。方法:对1999～2008年诊治的18例肝外伤术后大出血再手术治疗患者的临床资料进行回顾性分析。结果:按美国外科创伤协会的肝外伤分级标准,18例患者均为Ⅲ级以上损伤,首次术后出血量800～1700ml。18例均接受再次手术治疗,14例治愈,4例死亡,再手术病死率为22.22%(4/18)。结论:尽管肝外伤术后大出血病情重、治疗棘手,但只要处理得当,再次选择正确的手术方法进行迅速止血,仍能挽救多数患者的生命。

Objective：To sum up the experience in treating post-operative intraabdominal hemorrhage in patients with serve liver trauma by surgery.Methods：A total of 18 cases of post-operative re-hemorrhage that had been first operated on for severe liver trauma from 1999 to 2008 in our hospital were analyzed retrospectively.Results：According to AAST Classification,all the cases had trauma of degree Ⅲ or above.The post-operative intraabdominal hemorrhage of the patients reached 800-1 700 ml,and all received re-operation.Of the 18 cases,14 were cured and 4 died.The mortality rate was 22.22%.Conclusions：Timely re-operation is effective for treatment of post-operative intraabdominal hemorrhage in patients with severe liver trauma.It is essential to select appropriate operation methods in accordance to the condition of the patients.