闭合性肝损伤的早期诊断和治疗

Early Diagnosis and Treatment of Blunt Liver Trauma

目的 :总结闭合性肝损伤的诊断和治疗的经验。方法 :对 6 2例闭合性肝损伤病人的临床资料和诊治情况进行回顾性分析。结果 :6 2例肝损伤中属Ⅰ级 12例 (19.4 % ) ,Ⅱ级 15例 (2 1.2 % ) ,Ⅲ级 19例 (30 .6 % ) ,Ⅳ级 13例 (2 1.0 % ) ,Ⅴ级 3例(4.8% )。伴有合并伤 4 4例。非手术治疗 9例 ,治愈 8例 (88.8% ) ,死亡 1例 (11.2 % ) ;手术治疗 5 3例 ,治愈 4 8例 (90 .6 % ) ,死亡 5例 (9.4 % )。结论 :详细询问病史 ,细致的体格检查 ,以及重复腹腔穿刺和腹部B超检查 ,是早期诊断的关键。选择合理的治疗方法 ,积极处理合并症和并发症 。

Objective: To investigate the early diagnosis and treatment of blunt liver trauma. Methods: The clinical data of 62 cases of closed liver trauma were reviewed retrospectively. Results: Of the 62 cases,12 patients were in grade Ⅰliver injury;15 patients in grade Ⅱ;19 patients in grade Ⅲ; 13 patients in grade Ⅳ; 3 patients in grade Ⅴ.9 cases were treated by non-surgical therapy , 8 cases were cured and one died. Among the other 53 cases treated by surgery,48 were cured and five died. Conclusion: The key factors for early diagnosis are the history of the injury, the physical examine of abdomen, peritoneum puncture and B-ultrasonograph. The choice of surgical treatment and the treatment of complication can effectively cut down the mortality.