肝损伤331例诊治分析

Diagnostic and therapeutic analysis of 331 cases of liver damage

目的探讨肝损伤最有效的治疗方法。方法对病因、伤情分级、术前时间、手术方法、术后并发症、病死率作了统计和分析。结果1985年前、后交通事故致肝损伤分别为112例（112／178）和104例（104／119），肝损伤Ⅰ、Ⅱ级所占比例为13／297、74／297。1985年前创伤至手术前时间平均为17小时，1985年后平均为6小时。清创术病死率为19．39％（57／294），单纯肝损伤病死率为15．45％（19／123），合并伤病死率24．14％（42／174）。46例并发症均治愈。结论肝损伤要正确选择治疗方法，缩短手术前时间，积极处置合并伤，可降低病死率。

Objective In order to find out the best operative way. Methods We analyzed and made statistics ofpathogeny, classify of injury condition, the time be fore operation, complication after the operation and mortality. ResultsLiver damage resulted in traffic accident was 112 cases(112/178 ) before 1985, and after 1985 was104 cases(104/119). There was tending to increasing. Grade Ⅰ liver damage was 13/297, and grade Ⅱ liver damage was74/297. Theaverage time before opeation was 17 hours before 1985, and after 1985 was 6 hours. The mortality of debridement was19. 39 % (57/294 ), the progenosis of simple liver damage was good and the mortality was 15. 45 % (19/ 123 ), the mortality of incorporate damage was 24. 14 % (42/ 174 ). 46 patients with complication were recoveried. Conclusion Correcttherapeutic method is important for managing liver damage. Shortening the time before opeation and actively managingincorporate damage can reduce the mortality.