手术治疗外伤性肝破裂148例分析

Clinic analysis of the surgical treatment of 148 cases of traumatic ruptures of the livers

目的 探讨外伤性肝破裂的早期诊断及治疗方法。方法 分析自1975年1月至1999年5月间手术治疗外伤性肝破裂148例。结果 救治成功率为79.7％。死亡原因:失血性休克26例,脑挫裂伤、胆漏、腹腔感染、多脏器衰竭各1例。结论 早期诊断、早期手术对提高肝外伤存活率至关重要,对复杂性肝外伤宜采用肝动脉结扎、带蒂大网膜填塞、游离大网膜包裹等措施综合治疗。

Objective To explore the effective methods of the early diagnosis and treatment of ruptures of traumatic livers. Methods 148 cases of traumatic rupture the livers from January 1975 to may 1999 were analyzed and the importance of the early diagnosis of abdominal injury with the help of laparoscope accentuated. Results The successful rate of salvation is 79.7 % . Among 30 cases of deaths, 26 cases were caused by the shock because of the bleeding. The rest of the deaths resulted from the fracture of the brain, the spillage of the galls,the infection of abdominal cavities and the break down of several abdominal organs respectively. Conclusion It is important to undergo a timely diagnosis and operation. It is advisable to adopt the integrated treatment of the tricky traumatic rupture of the livers by knotting the hepatic arteries,infilling the zone rasoular of the big meshy membrane,swathing the floating big meshy membrane etc.