损伤控制性手术治疗严重创伤性肝破裂28例的临床观察

Damage control surgical treatment of traumatic serious liver rupture of 28 cases clinical observation

目的：总结损伤控制性手术（DCS）在严重创伤性肝破裂中的具体实施方法及经验，提高创伤性肝破裂的诊治水平。方法：回顾性分析我院28例严重创伤性肝破裂患者接受手术治疗的临床资料。其中Ⅲ级13例，Ⅳ级8例，Ⅴ级7例。结果：28例患者中痊愈25例，占89．29％；死亡3例，占10．71％，其死亡原因为多器官功能衰竭伴严重失血2例，合并严重脑挫伤1例。其中胆漏4例，腹腔脓肿3例，均治愈。结论：结论符合DCS指征的严重创伤性肝破裂的病人，应积极选择适宜的手术治疗方式，并应根据损伤的不同部位和程度，分次手术治疗。

Objective：This article damage control surgery （DCS） in serious traumatic liver rupture in the specific implementation method and experience,and improve the diagnosis and treatment of traumatic liver rupture level. Methods： retrospective analysis 28 cases with severe traumatic ruptured liver patient surgery clinical data. Among them Ⅲ level in 13, Ⅳ grade 8 cases, Ⅴ level 7 cases. Result ：28 patients recovered in the 25 patients （89.29 %; Death in 3,10.71%, the cause of his death is organ failure with severe blood loss,2 cases with severe cerebral contusion in one. Bile leakage of 4 cases, abdominal abscess,3 cases were cured. Conclusion： With DCS indications of conclusion of traumatic serious liver the breakdown of the patient, should actively choose appropriate surgical therapy treatment,and should be based on different parts of the injury and degree,The Times surgery.