儿童闭合性肝外伤的诊断与治疗-儿科学专业论文.docxVIP

英汉缩略语名词对照 英文缩写 英文全称 中文全称 AAST The American Association For The 美国创伤外科学会器官 Surgery Of Trauma ALT Alanine Aminotransferase 丙氨酸氨基转移酶 AST Aspartate Aminotransferase 天门冬氨酸氨基转移酶 DCS Damage Control Surgery 损伤控制性外科 1 儿童闭合性肝外伤的诊断与治疗 摘要 目的：探讨儿童闭合性肝外伤的临床特点及治疗方案的选择。 方法：回顾性分析本院 2001 年-2014 年收治 147 例儿童闭合性肝外伤 临床资料，对其临床表现、影像学分级及治疗方案进行回顾性分析。 按照 AAST 分级Ⅰ级 53 例，Ⅱ级 47 例，Ⅲ级 40 例，Ⅳ级 3 例，Ⅴ级 4 例，对治疗效果进行分析，并根据患儿各项临床表现进行评分。 结果：147 例患儿中 21 例行手术治疗，治愈 19 例，死亡 1 例，因失血 过多发生缺血缺氧性脑病 1 例，126 例行保守治疗，均痊愈出院。对其 进行评分，3 例患者分值为 7 分，8 分 3 例，9 分 1 例，10 分 5 例，11 分 4 例，12 分 3 例，13 分 2 例。非手术组评分均在 6 分以下。 结论：儿童闭合性肝外伤应根据临床表现、影像学检查等选择合理的 治疗方案。 关键词：儿童 闭合性肝外伤诊断 评分 治疗 2 DIAGNOSIS AND TREATMENT OF BLUNT HEPATIC TRAUMA IN CHILDREN ABSTRACT Objective: To explore the clinical characteristics and treatment methods of blunt hepatic trauma in children. Methods:A retrospective analysis of our hospital in 13 years were admitted to the clinical data of 147 cases of blunt hepatic trauma in children, clinical manifestation, imaging classification and treatment plan summary. According to the 53 cases of AAST grade I, 47 cases of grade II, III 40 cases, 3 cases of grade IV, 4 cases of grade V.According to the clinical manifestationgs of children with score. Results: 21 cases were treated by operation, 19 cases were cured, 1 case died, 1 case occurred hypoxic ischemic encephalopathy,126 cases underwent non-operative management, all of them were well recovered. Scoring, 3 patients were scored of 7 points, 8 points in 3 cases, 9 points in 1 cases, 10 points in 5 cases, 11 points in 4 cases, 12 points in 3 cases, 2 cases were 13 points. The non-operation group scores were below 6 points. Conclusion: Image the individualized treatment appropriate should according to clinical manifestation, hemodynamics, ultrasound and computed tomography in blunt hepatic trauma. 3 Key words: child; blunt hepatic trauma; diagnosis; score;treatment 4 儿童闭合性肝外伤的诊断与治疗 前言 肝脏位于膈肌下方季肋部，受到胸廓的保护，加之小儿肋骨柔韧性较好，一 般不容易损伤。但由于肝组织相对脆弱，儿童比成人肝脏体积比较大，肝脏可能 超过肋弓下缘；小儿自我保护能力