肝脏外伤68例临床治疗分析

目的：探讨基层医院肝外伤的诊断及不同治疗方法的选择。方法：对68例肝外伤病人的临床诊断、损伤程度、处理方法及疗效进行回顾性分析。结果：68例外伤性肝损伤病人中，Ⅲ以下46例，Ⅳ级以上22例。非手术治疗13例，手术治疗55你。治愈66例，死亡2例。结论：（1）肝外伤特别是闭合性肝外伤，诊断性腹腔穿刺仍是非常有价值的检查方法；（2）肝修补清创加大网膜填塞或缝合较好，明胶海绵不宜单独大量使用。（3）对严重出血，特别是肝后腔静脉及肝静脉损伤，肝周纱布填塞赕控制病情的措施。

Clinical treatment analysis of 68 cases of liver trauma

Objective: To discuss how to diagnose the trauma of liver and determine the therapy in grass-root hospitals. Methods: The author analyzed clinical diagnoses, conditions of the trauma, treatments and their effect in 68 cases of liver trauma.Results: Forty-six cases of them were under level 4 and 22 cases at level 4 and above. The non-operation therapies were used in 13 cases, and operations were done in 55 cases. Sixty-six of the cases were cured and 2 died. Conclusion: The diagnostic abdominocentesis is still a valuable examination for the trauma of liver, especially the closed trauma of liver. The debridement and neoplasty of liver plus epiploon tamponade or suturation are very effective but it is unadvisable to use a great deal of glutin sponge separately. The gauze tamponade of hepatic circumference can be a measure of controling the patients' condition for serious hemorrhage, especially the trauma of vena cava of hepatic backside and hepatic vein.