肝损伤临床分级及治疗方法的探讨

目的探讨肝损伤临床分级及2种治疗方法的比较。方法将近5年收治的闭合性肝损伤患者按治疗方法分为手术组86例及非手术组110例。比较2组患者住院天数、年龄等一般指标,同时监测2组患者入院时、治疗第3、第7 d及出院时血色素(HGB)、白细胞(WBC)、血小板(PLT)、直接胆红素(DBIL)、间接胆红素(IBIL)、天门冬氨酸转移酶(AST)、丙氨酸氨基转移酶(ALT)的动态变化。结果 2组患者年龄比较差异无统计学意义(P﹥0.05),住院天数非手术组较手术组缩短,有统计学意义(P﹤0.05)。DBIL、HGB 2组比较在4个时间段均有统计学意义(P﹤0.05);WBC、AST在治疗第7 d和出院时2组比较有统计学意义(P﹤0.05);PLT、IBIL、ALT2组比较在4个时间段差异均无统计学意义(P﹥0.05)。结论正确把握治疗原则,把握手术适应症,在血流动力学稳定及严密监测情况下,尽可能选择非手术治疗。

The discuss of clinic grading and treatment of hepatic trauma

Objective To discuss clinic grading and compare two different kinds of treatment about the hepatic trauma.Methods The patients with closed hepatic trauma hospitalized in past five years were selected,which were divided into operative group(n=86) and non-operative group(n=110) according to treatment.The hospital stay and age was compared.The HGB,WBC,PLT,IBIL,DBIL,AST and ALT were recorded and analyzed before the treatment and 3rd,7th day after treatment.Results There were no obvious difference in two groups about age(P>0.05),The hospital stay was shorter the non-operative group than that in operative group(P<0.05).There were significant difference in HGB and DBIL between two groups(P<0.05).There were significant difference in WBC and AST in 7th day after the treatment between two groups(P<0.05).There were no significant difference in PLT,IBIL and ALT between two groups at the four time points(P>0.05).Conclusion The treatment principle and the operation indication should be exactly chosen.Non-operative treatment would be better than operative treatment according to patients’ condition.