腹部大血管损伤17例报告

Major Abdominal Vascular Trauma: A Report of 17 Cases

本文报告17例腹部大血管损伤,其中肝后下腔静脉5例,肝下下腔静脉3例,门静脉3例,髂静脉5例,肾动、静脉1例。对该类病例尽快手术止血是抢救成功的关键。肝破裂并肝后腔静脉破裂者可用明胶海绵填塞、带蒂大网膜包盖、软绷带压迫,获得有效的止血;门静脉损伤尤其多裂口者,用一纱垫填入网膜孔,再用纱垫压迫肝十二指肠韧带,这样可满意地控制出血,便于损伤的修补。

This is a review of our experiences in 18 major abdominal vascular injuries in 17 patients in recent 20 years.Five injuries located in retrohepatic vena cava,3 in infra- hepatic vena cava,5 in iliac vein,3 in portal vein,I in renal pedical.All patients had systolic pressure less than 8 kpa at admission.The overall death rate was 52.9%. Our experiences suggest that patients with major abdominal vascular injuries should be transferred to the operating room as quickly as possible.Repid resuscitation and early operation are essential.We emphsize that injuries of introhepatic IVC and main trunk of portal vein are lethal and the hemorrhage shoud be controled as promptly as possible.For those with hepatic and retrohepatic vena cave injuries.the bleeding call be easiry controlled by coverage of the injurious area with spongy gelatin and omentum, followed by gauze packing.For trauma of the main trunk of portal vein,pack the Foramen Winslow and press the hepatic-duodenal ligament with gauze,repair can be performed rapidly and easily when hemorrhage is controlled by pressure.