手术治疗肝外伤近肝大血管损伤35例临床分析

Clinical study on surgical treatment for injury of liver and vascular approaching to liver with 35 Cases

目的探讨肝外伤近肝大血管损伤的手术方式和治疗效果。方法回顾性分析1997年1月至2010年5月我院手术治疗的肝外伤近肝大血管损伤35例患者的临床资料。结果35例患者中治愈32例（91．43％），死亡3例（8．57％）。术后并发肺部感染2例，胆瘘1例，多器官功能衰竭1例，切口感染1例，并发症发生率为14．29％（5／35）。结论肝外伤近肝大血管损伤需紧急手术，并注意有效复苏，术中操作仔细、游离彻底、暴露充分是成功修复的关键。

Objective To explore the surgical approach and therapeutic efficacy of injury of liver and vascular approaching to liver. Methods The clinical data from January 1997 to May 2010 of 35 patients with injury of liver and vascular approaching to liver were retrospectively ＇analyzed. Results Among 35 cases, 32 cases were cured by surgery （ cure rate 91.43% ） and 3 cases died （ mortality rate 8. 57% ）. Postoperative complications occurred in 5 patients （ complication rate 14. 29% ）. There were 2 cases of pulmonary infection , 1 case of biliary fistula, 1 case of multiple organ failure and 1 case of incision infection. Conclusion Urgent surgery need to be performed for injury of liver and vascular approaching to liver and effective recovery was important. In the operation, careful handling, complete dissociation and sufficient exposure were the key to successful repair.