综合救治法在重度肝脏创伤中的临床应用

Clinical application of complex surgical therapy was studied on severe hepatic trauma

目的 探讨提高重度肝脏创伤救治成功率的综合救治方法及合理救治流程。方法 我院 15年内收治的 46例重度肝脏创伤患者采取院前急救 ,术前多次检查确诊和手术治疗 ,就其院前、院后的综合救治法和救治流程的有关资料进行分析。结果 院前救治时间过长、术前无法明确诊断、伴 /不伴合并伤的严重肝裂伤致大量失血无法控制 ,以上三项与休克持续时间呈多元性线性正相关关系 (r =0 .5 5 ,t =3.38,P <0 .0 0 5 ) ,死亡率随休克持续时间增长而明显增高 (P <0 .0 1)。结论 缩短院前急救时间 ,迅速纠正休克 ,快速明确诊断并采用确定性手术 ,正确处理合并伤 ,是重度肝脏创伤的合理救治流程 。

Objective To study the application of complex surgical therapy of severe hepatic trauma and the flow line reasonable.Method To study the methods and reasonable process of complex surgical treatment of severe hepatic trauma pre-hospital or hospital treatment of 46 patients during the past 15 years.Results The time of sending to hospital was delayed.Patient has severe hepatic trauma or associated injuries.Patient can not be diagnosed definitely against time.Linear correlation was demonstrated between the three upon and shock (r=0.55,t=3.38,P<0.05).We can find the mortality of patients by long time to shock is high than that by short time(P<0.01).Conclusions To shorten the time before sending to hospital.We must salvage shock and take a specific diagnose against time.We also must adopt a decided operation most advisable.We will treat associated injuries in reason rightly at the same time. All of these will be the methods of reducing mortality of severe hepatic trauma effective.