肝外伤病人的围手术管理

Management of the Liver Trauma

目的：探讨围手术科学管理对肝外伤救治的意义。方法：回顾性对比分析我院自1995年8月~2000年12月108例肝外伤病例（Ⅰ组）和2001年1月~2012年10月期间收治的202例肝外伤病例（Ⅱ组）救治情况。结果：两组肝损伤严重程度和术中平均出血量,差异无统计学意义（χ2=4.17,P=0.383,P〉0.05）,而保守治疗的比例（χ2=8.084,P=0.012,P〈0.05）、院前急救时间（χ2=30.928,P=0.006）、术前抢救耗用时间（χ2=48.092,P=0.004）、术后并发症发生率、手术病死率在两组间的差异有统计学意义。近10年肝外伤抢救技术、围手术管理水平有明显提高。结论：围手术科学管理对肝外伤救治成功的意义重大,尤其术前正确判断伤情和建立绿色通道快速实施抢救,及时手术是抢救成功的关键。

Objective：To evaluate the significance of scientific management for perioperative patients with liver trauma.Methods：Retrospective comparative analysis of treatment of 108 cases of liver trauma（groupⅠ） in our hospital from August 1995 to December 2000 and 202 cases（groupⅡ） in the same hospital from January 2001 to October 2012 period.Results：Both the severity of liver injury was no significant difference,but there were significant differences between the two groups in the proportion of conservative treatment,the time of the first aid,the time spent in preoperative rescuing,the average blood loss during the operation,postoperative complication rate and surgical mortality.Conclusion：Scientific management for perioperative patients with liver trauma is very important,what’s more,a right judge to injury situation and the first aid for operation is the key to successful treatment.