外伤性肝破裂48例外科治疗体会

目的：观察肝破裂预后与肝破裂本身的类型、程度有关外，更与急救措施是否及时、得力以及合并伤情况有关。方法：采用单纯缝合、大网膜填塞、缝合并用明胶海绵压迫、不规则肝部分切除，纱布填塞、肝右动脉结扎、肝固有动脉结扎、大网膜纱布填塞附加胆总管减压。结果：痊愈43例，死亡5例，1例死于早期失血性休克，另4例死于腹腔感染、多脏器功能衰竭。结论：及时有效的复苏，做好肝实质损伤后出血的局部处理是救治肝破裂的关键。

The Comprehend of Surgical Treatment of 48 Cases of Injury Hepatorrhexis

Objective To observe the correlation between the degree of rupture, types of rupture and the prompt rescue in curing of injury hepatorrhexis. Methods Simple sewing, caul wad, stitch combined with gelatin sponge oppress, irregularity liver surgical mute, gauze wad, right branch of proper hepatic artery ligation, proper hepatic ariery ligation, and caul gauze wad together with common bile duct decompression were adopted to treat injury hepatorrhexis. Results 43 cases recovered and 5 cases died. 1 case died of nonage hemorrhagic shock and 4 cases died of abdominal cavity infection and MODS. Conclusion Prompt rescue and stop local bleeding in of liver injury are most critical for curing hepatorrhexis.