外伤性肝破裂52例诊治体会

目的分析肝脏外伤的特点及其诊治方法。方法对1996年1月-2005年12月年本院收治创伤性肝破裂52例进行回顾性分析。其中Ⅲ级以上的严重肝破裂37例。手术治疗51例,手术方式包括单纯修补、清创性肝切除、肝周填塞止血:非手术治疗1例。结果:手术组:治愈49例,术后死亡2例:非手术组1例治愈结论:I级单纯性外伤性肝破裂可保守治疗;手术是治疗创伤性肝破裂的主要措施。确切止血,仔细结扎胆管,充分通畅的引流及术后抗生素扣支持治疗是防止并发症的关键。

Experience in the diagnosis and treatment of traumatic rupture of liver

Objective To investigate the feature of hepatic trauma and it's diagnosis and therapeutic methods.Methods From January 1996 to December 2005,52 cases with traumatic rupture of liver were analyzed retrospectively.Among them,the severe hepatic rupture was more than grade III in 37 cases.Operative treatment was 57 cases,including simple repair,debridement and hepatectomy,peri-hepatic hemostasis with packs.Conservative treatment was in 1 case.Results Operative group:49 cases were cured.2 cases died after operation.Conservative group:1 case was cured.Conclusion Conservative treatment can use in the grade I simple traumatic rupture of liver.Operative treatment is an important measure to traumatic rupture of liver.Precise hemostasis,meticulous ligation of biliary duct,enough unobstructed drainage,postoperative use of antibiotic and supporting treatment are keys to prevent the complications.