67例肝外伤合并多脏器损伤的临床救治分析

Analysis of the Clinical Treatment about 67 Cases of Liver Trauma with Multiple Organ Injury

目的:分析肝外伤合并多脏器损伤的临床救治,为抢救方案的选择提供参考。方法:选择我院收治的肝外伤合并多脏器损伤的患者67例,根据受伤部位、严重程度的不同分别给予手术治疗和非手术治疗。其中非手术治疗12例;手术治疗55例,其中行肝清创切除术35例,肝清创缝合术12例,肝周纱布堵塞术8例。同时进行脾切除23例、胰体尾切除18例、胃修补17例,肾修补18例,膀胱修补并造瘘术16例,血管修补术15例。结果:非手术治疗患者死亡1例,死亡率为8.33%;手术治疗患者术后出现并发症7例,其中死亡5例,术后并发症发生率为12.73%,死亡率为9.09%,其余患者均痊愈出院。6例死亡患者中,死亡原因为失血性休克5例,多器官功能衰竭1例。结论:早期明确诊断、及时进行非手术或手术治疗,对肝外伤合并多脏器损伤的恢复起到关键作用。

Objective：Analysis of liver trauma with multiple organ damage in clinical treatment,give a choice for clinical rescue.Method：Chose 67 cases of liver trauma with multiple organ injuryl.According to the injury site and degree,12 cases of non surgical treatment;55 cases of surgery,liver resection in 35 cases,liver debridement in 12 cases,liver gauze plug in 18 cases.Splenectomy in 23 cases,pancreatic resection in 18 cases,gastric repair in 17 cases,renal repair in 18 cases,bladder repair and gastrostomy in 16 cases,15 cases of vascular repair.Results：Cases of non surgical treatment with 1 died,the mortality rate was 8.33%,cases of surgical treatment with postoperative complications in 7 cases,including 5 deaths,postoperative complication rate was 12.73 %,the mortality rate of 9.09%,and the remaining cases left hospital.5 cases dead of hemorrhagic shock,1 case dead of multiple organ failure.Conclusion：Early diagnosis and timely non-surgical or surgical treatment of liver trauma with multiple organ injuries play a key role in the recovery.