诊治和探讨以肝脏为主的多发性创伤

目的：探讨以肝脏损伤为主的多发性创伤的诊治策略，提高肝外伤的救治水平。方法：回顾性总结分析34例以肝脏为主的多发性创伤的诊断方法、急救措施和治疗结果。结果：诊断性腹腔穿刺的阳性率为97％；手术34例，治愈28例，死亡6例（17．65％）。死亡原因主要为MOSF、严重的失血性休克和急性肾功能衰竭。结论：详细询问病史、诊断性腹腔穿刺是肝外伤的有效诊断措施；纱布填塞术对严重肝外伤大出血的救治仍不失为一种有效的手术方法。

Discussion of diagnosis and treatment of liver injury combined with multiple injury

Objective:Discussion of diagnostic steps and management of liver injury combined with multiple injury.Methods:We retrogradely analysed diagnostic steps and treatment results of 34 patients of liver injury.Results:Positive rate of abdominal puncture was 97%,34 patients were treatde by surgical operation and 6 patients died.Major cause of death were MOSF,seriously bleeding shock and acute renal failure.Conclusion:Carefully asking the history and diagnostic abdominal puncture were effective steps for diagnosis of liver injury.Gauze packing was an effective treatment way for the seriously liver injury.