肝脏损伤诊治进展.pdfVIP

·292· 文章编号：1009—423712008)04—0292一03 ·专家论坛· 肝脏损伤诊治进展 高劲谋 (重庆市急救医疗中心创伤科，重庆400014) 摘要： 随着影像学诊断和治疗技术的进展，肝脏损伤的非手术治疗越来越多地被接受。但对于有致命性大出血的严重 肝脏损伤，尤其伴有肝后静脉损伤时，多予手术治疗，且死亡率和并发症发生率高。按照肝脏损伤的级别合理采用综合手术 治疗方法，将明显改善治疗效果，第一肝门阻断(蹦ngle法)下肝切除是一重要治疗手段。肝后静脉损伤的主要对策是全肝血 流阻断或转流下肝切除或肝切开显露和修补肝后静脉；难以耐受此术式时，肝周填塞是明智的选择。 关键词：肝脏损伤；止血；手术；填塞 中图分类号：R657．3 文献标识码：A andtreanIlentforlivertra哪 Irogre鹳ofmagnosis GH0以n-，加u of Medical (Department7Iraumto蛔。Chongq岖Emergencycenter。chongqing400014，china) With Abst眦t： adV锄cemen“n aIldinterventionaI more withlivertra哪a阳trea． imagingdia印08is therapy，more觚dpatients ted In severe those venous non叩eratiVely． patients稍tllh印砒icinjudes，however，especiany船sociated衍tllpost-hep“cjnjuI)r，9pem— tiVetI℃atmentis to associated耐th of emca— be fbquentlyu8ed，and“continues highmorbidity锄drnortality．Improvementtherapeutic canbeobtainedbasedonreasonable totheclassificationoflivertmumathe cy option“8urgicalpmceduresaccording duringoperation． or occlu8ionofthe triad m肌euver f打treatment0fse- Hepatectomy。regularin．egular。under portal byPrinde i8觚important technique Ve陀liVertrauma．Tbdealwith ve∞us be canachievedvia post·hepaticinjuries，sometimes，directexposure舳drepair hemihepatecto- undertotalv船cularocclusi叫． nlose whoc柚，t 8uch myorhepatotomyhepatic Facing patients toleyateprocedure-