严重交通事故致外伤性肝破裂86例临床分析

Clinical Analysis of 86 Patients with Liver Traumatic Rupture Induced by Severe Traffic Accidents

目的：总结分析严重交通事故致外伤性肝破裂的临床特点及治疗情况。方法：选择2009年6月-2012年11月期间我院收治的86例严重交通事故致外伤性肝破裂患者为研究对象,分别根据病情选择保守治疗或手术治疗措施,分析治愈情况。结果：临床特点：①闭合性肝损伤比例82.56%明显高于开放性损伤比例17.44%,差异显著（P〈0.05）；②伴发伤中肋骨骨折、胰腺及脾脏受损比例高于其他损伤部位；③AAST分类中,76.53%的患者属于Ⅰ级、Ⅱ级,其中Ⅰ级损伤比例明显高于其他级别,差异显著（P〈0.05）。经保守治疗和手术治疗后82例痊愈,治愈率95.35%,术后6例（6.98%）发生血肿、感染、胆瘘等并发症,对症治疗后痊愈。结论：交通事故伤者外伤性肝破裂要及时诊断,选择合理的手术方式是提高预后的关键。

Objective：The objective of the present study was to analyze and summarize clinical characteristics and treatment of patients with liver traumatic rupture induced by severe traffic accidents.Methods：86 patients with liver traumatic rupture induced by severe traffic accidents were recruited and cured in our hospital from June of 2009 to November of 2012, and the patients were selected as research subjects in the present study. The patients were treated with conservative treatment or operation treatment according to patients’ conditions, and treatment effects were analyzed.Results：In respect to clinical characteristics, the proportion of blunt hepatic injury was 82.56%, which was obviously higher than that of open hepatic injury（17.44%）, and there were statistical significance between these two proportions（P〈0.05）. The proportions of rib fracture with traumatic rupture, and damages of pancreas and spleen were higher than that of other injury sites. In AAST classification, 76.53%patients belonged to I class and II class, in which the proportion of class I damage was obviously higher than that of other classes, and there were significant differences between proportion of class I damage and proportions of other class damages（P〈0.05）. 82 patients recovered after conservative treatment or operation treatment, and the recovery rate was 95.35%. There were 6 patients with complications of hematoma, infection, and biliary fistula after operation, and the complication rate was 6.98%, and the patients also recovered after symptomatic treatment.Conclusion：Patients with liver traumatic rupture induced by traffic accidents should be diagnosed timely, and it is a key to increase prognoses by selecting reasonable operation methods.