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Severe liver trauma prevention of postoperative complications (Analysis of 26 Cases)

Surgery, Second People's Hospital, 257 447) Key words Surgery; sprouts Lantai d l in our hospital from 1980 to 5 years were treated as a serious one and 26 cases of extrahepatic. 2 patients died on the spot,[link widoczny dla zalogowanych], and the Divination disease occurred 8 down, 1 patient died of complications is now well on the causes of complications and preventive measures to be analyzed. 1 Information debate diagnostic criteria and methods ① gap length L1 is greater than lOcm,[link widoczny dla zalogowanych], and deep selection of liver parenchyma or liver lobe was star wide | Pan loss or ~ 1 and a huge hematoma in the central liver lobe - ② 1 and liver damage associated with liver inferior vena cava after the loss of about 1 and t @ across a wide range of liver laceration. Those who have more than one can be diagnosed as severe liver injury 1.2 General Information The group M 18. 8 females; aged 16 to 60-year-old causes of injury: a car accident 2】 cases, 2 cases by falling knife stabbed in 2 cases,[link widoczny dla zalogowanych], 1 and 1 case of the top horn. Loss of 1 and areas: the right hepatic l9 case, left the liver in 5 cases, left and right across the back with brain outside the liver 2, 1 and 3. Taiwan and other Mu-control intra-abdominal injuries in 5 cases. When this group became ill and eight homes were hemorrhagic shock. 1.3 surgical suture gap 7 cases of simple, clear film cavity filling a sponge or large A suture L4 cases, lobectomy in 2 cases. Gauze packing in 3. 2 Results for this group 2 cases of liver injury was star wide Joseph, was killed outside valid gauze packing, 2I down 8 down a successful surgery to stop bleeding complications. Died from complications of a fall. 3 Discussion 3.1 The secondary causes of bleeding: ① in severe liver damage, no time when exploration. Forced to use large gauze packing, remove the gauze after 3 days of secondary bleeding wound. @ Postoperative infection in liver tissue necrosis, corrosion, blood vessels, bile ducts. ③ patients lose large set short-term inventory of blood clotting mechanism resulting】 stick in the wounds caused by bleeding. Upon group sets and secondary hemorrhage in 2 cases, 1 case of gauze for 3 days later due to every 1 male and surgical drainage of infection under the first Lo-day biliary tract bleeding, the re-bleeding and surgical plane more thoroughly cleaned. Through the above cases where we feel should be corrected as soon as possible shock, adequate drainage, liver wounds left l72 · cut hasty foot injury Song c ;_]<, dead space. Severe liver injury to stop bleeding, use gauze packing is simple and quick way to save Hu, but re-bleeding after infection and therefore easy to claim that we should be preferred irregular hepatectomy, another tomb filled with suture of pedicled omentum or omental large external tongue around the liver section gauze packing, Feng law can be both obliteration of dead space to control the bleeding. For liver tissue repair, when the gauze removed, the liver is still omental wrapping, cover. To avoid secondary bleeding. Pina for coagulation control secondary bleeding disorders. Wing can be applied to correct electrolyte imbalance. Intravenous infusion of platelets, albumin, fresh plasma and other combination therapy. 3.2 Upon group 3 bile leakage, liver damage and more reason to stick in the door or in the】 huge star for a wide range laceration, the use of gauze packing emergency treatment failed to complete loss of one and the bile duct ligation; also caused by infection with the liver 】 stick in organizations related to the hepatic duct necrosis. 2 patients treated by peritoneal drainage L8, 22 days, the fistula was closed and the more their own. Another 1 case associated with colon injury, complicated by diffuse peritonitis in 7 days after death. We understand; such as biliary fistula, just keep drainage flow. Including strict infection control, maintenance of electrolyte balance forever. Strengthening support for treatment, liver tissue can be gradually restored, self-closing. 3.3 3 cases of abdominal infection in this group, after treatment and more, the site of infection in the liver, diaphragm in 1 case, and the other L cases of liver, diaphragm, has the right chest infection, patients showed persistent high fever. In addition to this patient's antibiotic use and efficient set foot outside. Finding a skewer or in subphrenic effusion, hemorrhage, empyema, should be guided in the B-percutaneous aspiration or catheter drainage. When necessary, surgical exploration can be used to strengthen the body supportive therapy and other measures.
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