清创性肝切除术在重度肝外伤应用的回顾性分析

Retrospective analysis of application of debridement hepatectomy in severe liver trauma

目的:分析清创性肝切除术在重度肝外伤中的应用疗效。方法:回顾性分析40例重度肝外伤手术治疗病例,比较不同手术方式的死亡率并分析死亡原因。结果:清创性肝切除术的死亡率为36.8%,相对危险度(relative rissk,RR)为0.71;规则性肝切除术的死亡率为54.5%,RR为1.27;大静脉(肝静脉或肝后下腔静脉)修补术死亡率为50.0%,RR为1.49。清创性肝切除术的死亡率明显低于规则性肝切除术和大静脉修补术(P<0.05)。总体手术死亡率为45.0%,其中肝脏相关疾病占35.0%,肝脏无关疾病占10.0%。结论:清创性肝切除术较传统规则性肝叶切除术在治疗重度肝外伤中更有助于降低手术死亡率。

Objective：To investigate the curative effect of debridement hepatectomy on severe liver trauma. Method ：40 cases of severe liver trauma surgery were retrospectively analyzed, with death rate in different operative methods compared, and cause of death analyzed. Results：The operative mortality in debridement hepatectomy was 36.8 % ,relative risk （RR） 0.71, in regular hepateetomy 54.5 %, RR 1.27, in vena cava （ hepatic vein or retrohepatic inferior vena cava） neoplasty 50.0 %, RR 1.49. The operative mortality in debridement hepatectomy was significant- ly lower than that both in regular hepatectomy and in vena cava neop]asty（ P 〈 0.05 ）. The overall operative mortality was 45.0 %, among which liver - related disease accounted for 35 %, not - liver - related disease 10 %. Conclusions ： There is a lower operative mortality of blunt hepatic se- vere injuries by using debridement hepatectomy than anatomical hepateetomy.