| 刘吉佳,刘君毅.严重肝外伤的处理(附11例分析).[J].中南医学科学杂志.,1987,(4):. |
| 严重肝外伤的处理(附11例分析) |
| MANAGEMENT OF SEVERE INJURY OF THE LIVER |
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| DOI： |
| 中文关键词: 肝损伤,处理 |
| 英文关键词:hepatic injury management |
| 基金项目: |
| 刘吉佳 刘君毅 |
| 衡阳医学院第二附属医院外科，衡阳医学院第二附属医院外科 |
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| 中文摘要: |
| 本文报告从1977年元月到1986年元月收治的11例严重肝外伤的处理,所有11例均做到术前正确诊断。手术方式:2例纱布填塞;4例单纯创口缝合,其中1例发生再出血,2例发生膈下脓肿再次手术;3例次清创式肝叶切除;2例不规则肝叶切除加T管引流。作者认为,严重肝外伤时,病人情况差,不宜做规则肝叶切除。急诊手术应当是迅速有效的止血,彻底清除失活肝组织和引流,必要时,可考虑作胆外胆管引流。 |
| 英文摘要: |
| During February 1977 to February 1986 eleven cases of severe hepatic injury had been treated. A correct diagnosis was made preoperatively in all the eases Various methods of treatment: included as follows, packing of the greatly damaged liver by large pieces of gauze. simple suturing of the lacerated liver tissue in four and among these unfortunated patients, bieeding occurred in one postoperatively, another two were complicated by subdiaphragmatic abscess who needed reoperation.Debridement of non-vital tissues was performed in three. Two patients treated by irregular partial hepatectomy and .the other two cured by partial hepatectomy plus insertion of a T-tube. The authors consider that a regular hepatectomy is not suitable owing to the very ill condition of the patient with severe injury of the liver.The first step of an emergency operation is to control the terrible hemorrhage rapidly and effectively.Thereafter, a thorough debridement to remove all the necrotic tissues of the injuried liver and silicon rubber tubes drainage of the bile follows. If necessary, an extrahepatie biliary tract drainage by applying of a T-tube may be considered. |
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