选择外伤性肝破裂非手术治疗预后影响因素分析.docVIP

选择外伤性肝破裂非手术治疗预后影响因素分析 　　【摘要】 目的：分析外伤性肝破裂非手术治疗预后的影响因素。方法：对选择的58例外伤性肝破裂患者行非手术治疗，分析其入院时的生命体征、腹腔出血量及肝破裂程度对预后的影响。结果：52例非手术治疗成功，成功率89.7%，6例中转手术治疗，发生率10.3%。AAST肝脏损伤分级、失血量对中转手术发生率有显著性影响（P500 ml，AAST分级Ⅲ级及其以上时，成功率明显降低。 　　【关键词】 肝损伤； 非手术治疗； 影响因素； 预后 　　中图分类号 R575 文献标识码 B 文章编号 1674-6805（2015）9-0018-03 　　On the Prognostic Factors of Choosing Non-surgical Treatment for Traumatic Hepatorrhexis/JIN Wan-liang.//Chinese and Foreign Medical Research，2015，13（9）：18-20 　　【Abstract】 Objective：To analyze the prognostic factors of choosing non-surgical treatment for traumatic hepatorrhexis.Method：It was to given non-surgical treatment to the 58 patients chosen with traumatic hepatorrhexis， and analyzed the effects of their vital signs， amount of intra-abdominal bleeding and hepatorrhexis degree on admission on the prognosis.Result：52 cases of non-surgical treatment were successful， with a success rate of 89.7%， and 6 cases were converted to surgical intervention， with an incidence rate of 10.3%. The contrastive analysis of the data showed that AAST liver traumatic division and blood loss volume had an obvious impact on the occurrence of conversive surgical intervention（P0.05）.Conclusion：If the hemodynamics is stable or stable after treatment， patients with traumatic hepatorrhexis can be considered to be given non-surgical treatment， as there often exists a satisfactory result. There is often a good prognosis of patients with stable blood pressure， little or no hemoperitoneum， as well as an AAST liver traumatic division lower than level Ⅱon admission. While it has a significantly lower success rate if the free blood volume in enterocoelia is higher than 500 ml after CT examination and the AAST division is or is higher than level Ⅲ. 　　【Key words】 Hepatic injury； Non-surgical treatment； Influence factors； Prognosis 　　First-author’s address： Zhongtang Hospital of Dongguan City，Dongguan 523220，China 　　doi：10.14033/j.cnki.cfmr.2015.09.007 　　肝脏是腹腔最大的实质性脏器，因其组织脆弱，内含丰富的血管和肝胆管，当收到外力作用时极易受损。在腹