肝外伤处理的进展与趋势

肝脏是体内最大的实质性器官.其外伤约占腹部创伤的20％左右,是较常见的腹部损伤器官.外伤所致肝破裂主要表现为腹腔内出血、腹膜刺激症状、失血性休克.如合并肝周大静脉损伤或合并多个脏器损伤,其死亡率很高.近年来,随着肝外伤研究的深入以及现代外科技术和设备的迅猛发展,肝外伤处理策略和手段发生了变化,如非手术治疗肝外伤病例逐渐增多,损伤控制性填塞方法的改善,快速通道外科理念在肝外伤的应用等等.

The advances and trends in the management of liver trauma

Liver is the largest parenchymal organ in human body and the most commonly injured organ in abdomen,accounting for 20％ of all abdominal traumas.Traumatic liver rupture can bring about intra-abdominal hemorrhage,peritoneal irritation and hemorrhagic shock.If the liver trauma takes place in peri-hepatic veins or multiple-organ injury,mortality rate is increased.In recent years,with more studies on liver injury and the rapid development of modern surgical techniques as well as the equipments,the strategies and means of liver trauma treatment have greatly changed.These changes include liver trauma cases with nonoperative treatment have been increased gradually,the improvement of damage control packing,the application of fast-track surgery concept in liver trauma,etc.