严重肝外伤术后并发症的原因及防治

目的 探讨严重肝外伤术后并发症发生的原因及防治方法.方法 回顾性分析2004年1月至2010年12月我院手术治疗的严重肝外伤患者76例,观察并发症类型、发生原因及治疗方法.结果 76例中7例(9.2％)出现并发症,共9例次,并发症发生率11.8％,其中术后出血1例次,胆瘘2例次,胸腔积液1例次,肝脓肿2例次,多器官功能衰竭( MODS)2例次,切 口感染1例次.7例出现并发症者治愈5例,死亡2例,均死于MODS.结论 严重肝外伤术中需彻底止血,有效清除坏死组织,通畅引流；术后注意保护肝功能,预防MODS,从而降低并发症发生率和病死率.

Prevention and treatment of postoperative complications of severe hepatic trauma

Objective To explore the causes, prevention and treatment of postoperative eomplications insevere hepatic： trauma. Methods Seventy-six cases of severe hepatic trauma treated with operation admitted were reviewed with regard to categories, causes and treatment of complications. Results Nine complications occurred in 7 cases with the incidence of 11.8% （9/76）. Among them, postoperative hemorrhage occurred in 1 case; biliaryfistula occurred in 2 cases; hydrothorax occurred in I case; hepatic abscess occurred in 2 cases; Multiple organ dysfunction syndrome （MODS） occurred in 2 cases; infection of incision occurred in 1 ease. 5 cases were cured, while the other 2 cases died of MODS. Conclusion There are some eft）ctive methods to reduce complications and mortality including complete hemostasis, efl）ctive drainage, proteelion of hepatic function and prevention of MODS.