外伤性肝破裂的综合外科治疗

目的 提高外伤性肝破裂的外科治疗水平。方法 回顾分析1987年9月至2001年1月间我科收治的外伤性肝破裂210例所采取的外科处理原则、手术术式的选择、治疗的结果、以及手术治疗的指征。结果 本组病例采取综合手术治疗198例，存活182例，其治愈率92％；非手术治疗12例，全部治愈，主要死亡原因为严重合并伤，严重休克。结论 综合选择手术术式可以明显提高手术成功率及减少并发症，严格掌握非手术治疗的适应症可以提高治愈率，清创加大网膜填塞修补术、肝修补术、选择性肝动脉结扎及清创性肝切除术为解决肝破裂的主要手段。

Comprehensive Surgical Therapy for Traumatic Hepatic Break

Objective To raise level of surgical therapy for patients with traumatic hepatic break.Methods We retrospective analyzed 210 cases of traumatic hepatic break at admission from Sep 1987 to Jan 2001.Result Among 198 patients comprehensive operation,182 were cured, the cure rate was 92%.12 patients were all cured by conservative treatment.Severe shock and the main reasons of death were severe traumatic complications.Conclusions Comprehensive operation can greatly improve the succesful rate and reduce the complication,strictly grasping the indication of conservative treatment can greatly improve the cure rate,we consider that the debridement plus packing with the big omentam,selective ligation of hepatic artery and debriding hepatectomy are mainly procedures for the treatment of the patients with tramatic hepatic rupture.