87例外伤性肝破裂诊治分析

目的 总结闭合肝损伤的诊断和治疗经验。方法 对1994～2007年外伤性闭合肝破裂87例的临床资料进行分析。结果 87例病人中，保守治疗5例，其中1例转开腹手术，28例行单纯缝合修补术，16例行肝清创L形管引流术，附加肝动脉结扎术2例，31例行清创大网膜填塞术，7例行清创性肝部分切除术；治愈85例，死亡2例。并发切口感染3例，肝功能损害17例，肝内积液1例，胆汁漏1例，经保守治疗治愈。结论 正确的早期诊断和手术治疗是提高肝外伤救治成功率，减少并发症和降低死亡率的关键。

The Diagnosis and Treatment of 87 Cases with Liver Rupture

Objective To sum up the diagnosis and treatment experience of close live injury. Methods Clinical data of 87cases with traumatic live rapture were analysed from 1994 to 2007. Results In 87 cases, 5 cases were treated with conservative way, among which 1 case was with laparotomy. 28 cases were done with simple suture repair. 16 cases were liver debridement of the L-shaped tube drainage. 2 cases were additional hepatic artery ligation. 31 cases were with packing of great omentum. 7 cases were liver dysfunction. 1 case was intrahepatic effusion and 1 case has bile leakage. They were cured with conservative way. Conclusion Early diagnosis and treatment are to improve the success of tramatic liver and reduce the complications and mortality.