闭合性肝损伤的急救治疗(附58例临床分析)

目的　提高对闭合性肝外伤的急救治疗水平。方法　分析 5 8例闭合性肝外伤急救治疗 ,其中手术治疗 5 6例 ,非手术治疗 2例。结果　轻度肝外伤 16例全部治愈 ,重度肝外伤死亡 3例。术后并发症为膈下感染 3例 ,胸腔积液 4例 ,腹腔感染 2例 ,切口液化感染 6例 ,合并肝创面再出血 2例 ,胆瘘 1例 ,胆管出血1例。结论　闭合性肝外伤以手术治疗为主 ,术中不结扎肝动脉 ,术中止血以速即纱止血片效果为好。必要时采用不规则肝切除 ,放置双套管引流有利于术后恢复

Critical Treatment on Closed Liver Trauma of 58 Cases

Objective To improve the critical treatment of closed liver trauma. Methods The data of 58 cases of different therapeutic means on closed liver trauma were analyzed including 56 cases with operation treatment and 2 cases conservative treatment. Results All the 16 cases of mild liver trauma were cured. 3 cases of severe liver trauma died. Postoperative complications included 3 cases of subphrenic infection, 4 cases of pleural hydrops, 2 cases of intraabdominal infection, 6 cases of liquefied incisional infection, 2 cases of combined incisional rebleeding, 1 case of gallbladder leak and 1 case of bile duct bleeding. Conclusion Closed liver trauma should be treated by operation. The liver artery should not be ligated during the operation. Sujisha tablets could give the best result to stop bleeding. Irregular liver resection could be taken when needed using double casing pipe for drainage was good for recovering after the operation.