外伤性肝破裂预后危险因素探讨

Liver traumatic rupture:an analysis of the risk factors for prognosis

目的分析外伤性肝破裂预后的危险因素。方法对中国人民解放军第101医院2005年6月至2010年6月收治的118例外伤性肝破裂病人入院时的临床指标进行单因素分析和Logistic回归分析。结果 118例病人中有并发症43例,发生率为36.4%,死亡10例,病死率为8.5%。单因素分析表明收缩压、脉率、受伤至入院时间、AAST肝脏损伤分级、失血量对并发症发生率有着显著影响(P<0.05)。Logistic回归分析提示收缩压、失血量、受伤至就诊时间、肝脏损伤分级是影响肝破裂预后的独立因素。结论临床中需重视影响肝破裂预后的各项因素,对病情做出准确判断,制定合适的治疗方案,有助于提高肝外伤的救治成功率。

Objective To analyze the risk factors for prognosis in liver traumatic rupture. Methods The clinical data of 118 patients with liver traumatic rupture admitted between June 2005 and June 2010 in the 101th Hospital of PLA were analyzed retrospectively. Statistical analysis was performed univariate analysis and multivariate logistic regression. Results Complications occured in 43 patients with the overall incidence of 36.4%. Ten patients died with the mortality of 8.5%. Results of univariate analysis indicated： SBP （systolic blood pressure）, PR （pulse rate）, time on admission, injury grade by AAST （American Association Surgery of Trauma）, the volume of blood loss are significant factors that influence the complication incidence for liver traumatic rupture （P〈0.05）. Multivariate logistic regression indicated ： SBP, the volume of blood loss, time on admission and injury grade were independent predictors for prognosis in liver traumatic rupture. Conclusion It should pay attention to all the factors that influence the prognosis in liver traumatic rupture in clinical work. Exact judgement and appropriate treatment plan are helpful to increase achievement ratio of liver traumatic rupture.