肝后下腔静脉非医源性损伤修复方法探讨

Treatment of non iatrogenic injury of retrohepatic inferior vena cava

目的 探讨伴发于肝外伤的肝后下腔静脉损伤的修复方法。 方法 对 6例肝后下腔静脉损伤患者采用压迫阻断受损肝后下腔静脉本身并阻断第一肝门 ,在无血状态下缝合下腔静脉裂口。 结果 修复 6例肝后下腔静脉损伤 ,下腔静脉裂口长度平均为 2 9cm(1 5～ 4cm) ,下腔静脉阻断时间平均为 9 2min(6～ 15min) ,第一肝门阻断时间平均为 2 0 5min(15～ 2 9min) ,全组患者均顺利恢复 ,B超、CT检查证实肝后下腔静脉通畅 ,无狭窄。 结论 肝外伤伴发的肝后下腔静脉撕裂伤可通过直接压迫阻断受损下腔静脉进行修复。

Objective[WT5”BZ] To study a repair method for injured retrohepatic inferior vena cava (IVC) associated with liver trauma. [WT5”HZ]Methods[WT5”BZ] Laceration of IVC was sutured bloodlessly after the injured retrohepatic IVC was occluded by compression combined with occlusion of the first hepatic hilus. [WT5”HZ]Results[WT5”BZ] From April 1996 to January 1999, the injured IVC was successfully repaired in 6 patients. The length of laceration was 2 9 cm (1 5-4 cm). The occlusion time was 9 2 min (6-15 min) for the IVC and 20 5 min (15-29 min) for the first hepatic hilus,respectively. All patients recovered uneventfully, and the IVC was patency without stricture as showed by B mode ultrasonography and CT. [WT5”HZ]Conclusion[WT5”BZ] The injured retrohepatic IVC can be repaired by direct compression when the laceration of the IVC is caused by liver trauma. [WT5”HZ]