国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2009年
2期
83-86
,共4页
戚悠飞%肖占祥%周开伦%吴奕强%邢贻雷%郑进方%张震生%陈劲松%吴昌雄%梁安林%耿林
慼悠飛%肖佔祥%週開倫%吳奕彊%邢貽雷%鄭進方%張震生%陳勁鬆%吳昌雄%樑安林%耿林
척유비%초점상%주개륜%오혁강%형이뢰%정진방%장진생%진경송%오창웅%량안림%경림
肝脏外伤%血流动力学%手术治疗%非手术治疗
肝髒外傷%血流動力學%手術治療%非手術治療
간장외상%혈류동역학%수술치료%비수술치료
hepatic trauma%hemodynamics%operative management%nonoperative management
目的 总结肝脏外伤的诊治经验.方法 回顾性总结1988年1月～2007年12月260例肝脏外伤病例的临床资料,包括损伤程度、治疗方式、治疗效果和并发症等.结果 经开放于术治疗153例,非手术治疗107例.236例治愈,24例死亡,病死率为10.2%,其中,肝脏损伤Ⅰ～Ⅱ级139例,死亡0例;Ⅲ-Ⅴ级119例,死亡22例;Ⅵ级2例均死亡,死亡与肝脏损伤级别相关.并发症发生82例次,主要包括继发性出血、腹腔感染等.结论 血流动力学稳定的肝脏外伤患者可在有效监护下选择非手术治疗,血流动力学不稳定的患者应及时于术止血,多学科的协作处理可扩大非手术治疗的应用,减少并发症.
目的 總結肝髒外傷的診治經驗.方法 迴顧性總結1988年1月～2007年12月260例肝髒外傷病例的臨床資料,包括損傷程度、治療方式、治療效果和併髮癥等.結果 經開放于術治療153例,非手術治療107例.236例治愈,24例死亡,病死率為10.2%,其中,肝髒損傷Ⅰ～Ⅱ級139例,死亡0例;Ⅲ-Ⅴ級119例,死亡22例;Ⅵ級2例均死亡,死亡與肝髒損傷級彆相關.併髮癥髮生82例次,主要包括繼髮性齣血、腹腔感染等.結論 血流動力學穩定的肝髒外傷患者可在有效鑑護下選擇非手術治療,血流動力學不穩定的患者應及時于術止血,多學科的協作處理可擴大非手術治療的應用,減少併髮癥.
목적 총결간장외상적진치경험.방법 회고성총결1988년1월～2007년12월260례간장외상병례적림상자료,포괄손상정도、치료방식、치료효과화병발증등.결과 경개방우술치료153례,비수술치료107례.236례치유,24례사망,병사솔위10.2%,기중,간장손상Ⅰ～Ⅱ급139례,사망0례;Ⅲ-Ⅴ급119례,사망22례;Ⅵ급2례균사망,사망여간장손상급별상관.병발증발생82례차,주요포괄계발성출혈、복강감염등.결론 혈류동역학은정적간장외상환자가재유효감호하선택비수술치료,혈류동역학불은정적환자응급시우술지혈,다학과적협작처리가확대비수술치료적응용,감소병발증.
Objective To summarize the experience in the diagnosis and treatment of hepatic trauma. Methods The clinical data of 260 patients with hepatic trauma admitted from January 1988 to December 2007 were retrospectively reviewed with regard to degree of trauma, treatment methods, therapeutical effects, complications and SO on. Results One hundred and fifty-three eases were treated by operative management,1 07 cases by nonoperative management.236 cases were cured,24 cases died,and the case fatality rate was 10.2%.There were no death among 139 patients with hepatic trauma grades Ⅰ～Ⅱ,22 death among 119 grades Ⅲ～Ⅴ patients, all death of 2 in grade VI, which demonstrated the correlation between death and hepatic trauma grade was statistically significant. Complications appeared in 82 eases, mainly including Secondary hemorrhage, abdominal infection and so on. Conclusions Nonoperative management is suitable for hepatic trauma with stable hemodynamics. Operative management is rapidly selected when the hemodynamics aren't stable. The cooperation of many specialities can enlarge the application of nonoperative management and decrease complications.
