钝性腹部闭合性损伤致肝破裂43例的治疗

目的：分析治疗钝性腹部闭合伤致肝破裂的临床疗效。方法：回顾性分析用不同方法治疗钝性腹部闭合伤致肝破裂43例。根据患者情况，行保守治疗9例，手术治疗34例。结果：治愈41例，因脑外伤致1例死亡。术中出血死亡1例。术后出现并发症5例，胆汁瘘1例，膈下脓肿1例，应急性溃疡1例，肺感染1例，胆道出血1例，均治愈。结论：除据患者病史症状外，诊断性腹腔穿刺，B超及CT检查是对腹部闭合伤致肝破裂早期诊断的有效手段。保守治疗基于对生命体征的严密观察及积极的基础治疗。具体的手术方法根据肝脏损伤情况，有效止血，清除失活组织及充分引流决定。

Treatment of 43 cases of broken liver resulted from blunt shut abdominal injury

Objective To explore the clinical effect of broken liver due to blunt shut abdominal injury.Method Fourty-three cases with broken liver due to blunt shut abdominal injury were reviewed.Nine cases were provided conservative treatment and other 34 were offered surgical treatment.Results Nine 9 were cured in conservative treatment and 4 were transfored for surgery in 34 of surgical operation group,and total 41 patients were cured and 2 were died in surgery group because of uncontrolled bleeding during operation and brain injury after operation.Five cases showed postoperative complications as 1 case of bile fistula,1 of subphrenic abscess,1 of stress ulcer,1 of lung infection,and 1 of emobilia,and all were cured.Conclusion The diagnostic belly cavity stab,B ultrasonic and CT exam are the important diagnosis meaning for liver broke due to blunt shut abdominal injury.Therapeutic methods are taken depending on the vital signs and degree of injury.Conservative treatment in theⅠ-Ⅱclass injury is based on tight observation of blood dynamics stability and the basic effective treatments.Methods of operation are based on liver damages,effective hemostasis and sufficient drainages.