小儿严重肝外伤的手术治疗

Treatment for Serious Hepatic Trauma in Children

本文报道小儿严重肝外伤26例,治愈率为80.8%,病死率19.2%.处理的方法根据肝受伤情况不同分为:清创缝合、填塞、胆道引流、肝动脉结扎和肝叶切除.充分显露、全面探查和仔细止血是处理小儿严重肝外伤的关键.术后妥善处理可预防并发症的发生.

26 cases with serious hepatic trauma in chil dren are reported. According to the injured liver and children's system characterestics after trauma, several methods of treatment were used respec-tively.The cural rate was up to 80.8%, while the mortality was only 19.2%. The latter is obviously lower than the mortality in literature (50%) .Weil-approach careful-exploratory, effective hemostasis plays an important part in the treatment of hepatic trauma in children.Indication and several techniques of opera -tion incSudings hepatic rupture debridment and mattress suture, choledochostomy, hepatic artery ligation and hepatic lobectomy were discussed .About postoperative management we also provide our experience.