肝脏损伤的诊治分析

Diagnostic and therapeutic analysis of hepatic trauma

目的 :总结肝损伤的诊治经验。方法 :回顾分析 78例肝损伤资料。结果 :轻型肝损伤 5 6例 ,重型肝损伤 2 2例 ;治愈 72例 ,死亡 6例 ;病死率为 7.7% ;失血为主要的死亡原因。结论 :血流动力学稳定的Ⅰ～Ⅲ级肝损伤可试行非手术治疗 ;严重肝损伤应在抗休克的同时尽快手术 ;手术方式应根据术中情况合理选择 ;肝切除术是治疗严重肝损伤的有效方法 ;术中胆道减压或术后ENBD可有效地减少术后并发症。

Objective:To summarize the experience of diagnosis and treatment for hepatic trauma.Methods:Hepatic trauma of 78 cases were analyzed.Results:Grade Ⅰ～Ⅱ liver damage were in 56 cases,and grade Ⅲ～Ⅵ liver damage were in 22 cases. 72 cases were cured,six cases died,the overall mortality rate was 7.7%. Blood loss was the main cause of death.Conclusion:Being hemodynamic steady these cases in trauma grade Ⅰ～Ⅲ may be received nonoperating treatment;those severe hepatic trauma with hemodynamic unsteady should be rapidly operated in the time of anti-shock;the operative method should be determined accoding to specific condition;liver lobectomy is effective method to severe hepatic trauma;drainage of biliary tract or ENBD can reduced complication.