严重肝外伤23例手术术式探讨.pdfVIP

674 J Bengbl! Me!f ÇQ!l July 2QI0 ,Vol. 35 •No. 7 [文章编号] 1αXJ-22∞(2010)07揭，74础 ·临床医学· 严重肝外伤23 例子术术式探讨 纪忠 [摘要]町伪:探讨严重肝外伤手术和再手术术式选择及治疗效果。方串串:对23 例严重肝外伤患者行肝清创后缝合修补2 例， 大网膜填塞修补9 例，一期清创性肝切除8 例(其中 1 例同时行肝周纱布填塞) .单纯行肝周纱布填塞4 例(其中 2 例二期行 清创性肝切除) ;同时行脾切除3 例，胃修补 l 例。结果:23 例中，肝外伤皿级 13 例.N级8 例.V级2 例。 21 例治愈，未发生 严重并发症。 2 例死亡。结+告:手术是治疗严重肝外伤的有效方法。应根据患者的局部和全身情况，选择合理术式。条件允 许时，清创性肝切除术是最有效和并发症最少的手术方法。 [关键词]肝外伤;失血;肝切除术 [中国图书资料分类法分类号] R 657. 32 [文献标识码] A Exploration of the appropriate operative method for severe hepatic trauma: a report of 23ωS崎 JI Zhong (DepartTTuml 0/ Surgery • The First -1庐liated Hosp阳1 0/Bengbu Medical College ,Bengbu A础山 233∞4 ， Chi.oo) [Abstract] Objective: To explore the appropriate operativelre-operative methods and evaluate the outcomes of severe hepatic 国.uma. Metb创ls:Amo吨由23 patients suffered from severe hepatic traun烛，two patients accepted suture repair after debridement ,9 patien饵 accepted pluggi吨 repair by great omentum ,8 by hepatectomy( one alω 田ated wi由 ribbon ga四e plugging around the liver) ,and the other four accepted ribbon gauze pluggi吨 around the liver( two of 由e patients underwent s配侃出巧 he阳tectomy). Splenectomy was carried out for 3 patients and g.描回πhaphy was carried out for 1 阴阳nt.R酬dts:Amo吨由e 23 patients ,the hepatic trauma was gr时d 豁 mfor13c跑回， Nfor8cas饵， and V for 2 cωes，l\四pectively. Twenty one patients were cured without accompanying 响曲曲y ωmplications. Two patients died. Conclusions: Operation is an effective treatment for 配:vere he阳山 trauma. The choice of operative method depends on the situation of the patient. H 由e s町g衍y condition is appropriate. 也e hepatectomy