Nikhinson R A, Chikhachev A M, Khomenko V V, Korkin I V
Khirurgiia (Mosk). 1989 Jan(1):81-4.
The authors studied 222 cases of closed and open injuries to the liver and, in addition, had 5 patients who were treated for sequelae of injury (hemobilia, abscesses, biliary fistula of the liver). The diagnosis of open injuries to the liver is established without great difficulties; laparocentesis and laparoscopy are indicated in closed injury. The volume of the operation is determined by the character of the damage: closure of the hepatic wound proves sufficient in most patients; surgical debridement is necessary in deep extensive wounds; resection of the liver is resorted to in disturbed blood supply. The high postoperative mortality rate is due to the fact that 71.8% of patients had concurrent injuries of the liver, other abdominal organs, organs of other cavities, central nervous system, and the locomotor apparatus.
作者研究了222例肝脏闭合性和开放性损伤病例,此外,还有5例因损伤后遗症(肝内出血、脓肿、肝内胆管瘘)接受治疗的患者。肝脏开放性损伤的诊断并不困难;闭合性损伤时,需进行腹腔穿刺和腹腔镜检查。手术范围取决于损伤的性质:大多数患者肝伤口缝合即可;深部广泛伤口则需进行外科清创;血液供应紊乱时需行肝切除术。术后死亡率高是因为71.8%的患者同时合并肝脏、其他腹部器官、其他腔隙器官、中枢神经系统和运动器官的损伤。