ABSTRACT
Objective To explore the effect of damage control resuscitation in the treatment of severe liver injury.Methods We retrospectively analysed the clinical data of 86 cases of severe liver injury who had damage control resuscitation during a period of 10 years.Results In 86 cases of severe liver injury,10 patientsdied with mortality rate of 11.6%,and 76 patients were cured with cure rate of 88.4%.Conclusions Damage control resuscitation should be instituted throughout the whole perioperative process of severe liver injury,and early successful resuscitation is the key to improve the cure rate and reduce mortality.
ABSTRACT
Objective To study the early diagnosis and treatment of liver trauma.Methods Retrospective(analysis) of the clinical data of different therapeutic means for liver trauma was made on 124 cases of liver trauma.Of these, 99 patients underwent operative treatment and 25 patients nonoperative treatment .Results In nonoperative treatment group ,22 patients were cured and 3 patients changed to operation.In operative treatment group, including 3 non-opcrative treatment patients changed to opcration,95 patients were cured ,7 patients died.In this series,the cure rate was 94.4%(117/124); mortality rate was 5.6%(7/124),including 5 patients who died of major blood vessel injury ,and 2 patients who died of multiple organ failure. All patients with postoperative(complications) were cured, including subphrenic infection in 3(cases), hepatic(abscess) in 6 cases , pleural(hydrops) in 8 cases, incisional infection in 7 cases,and(intraabdominal)(abscess) in 2 cases. Conclutions Type I liver trauma can be treated by(nonoperation) ; type II～IV blunt liver trauma can be treated by(nonoperation) under the condition of hemodynamic stability and(intensive)(monitoring) .Type II～VI liver trauma accompanied by massive intra-abdominal bleeding and(injury) of other(organs) should be (operated) (emergently .)
ABSTRACT
Objective To explore the diagnosis and treatment of liver trauma.Methods A retrospectively analysis of clinical data of 160 cases of liver trauma, including 96 cases of blunt trauma and 64 cases of open trauma, was made.Results Among the 160 cases, one case with stage IV trauma and severe thoracic injury died 30min after admission. Among the other 159 cases, 45cases (9 cases of stage Ⅰ, 31 cases of stage Ⅱ and 5cases of cases Ⅲ) received nonoperative treatment, and 114cases (7 cases of stage Ⅱ, 67 cases of stage Ⅲ and 50 cases of stage Ⅳ) received operative therapy. In non-operative treatment group, the cure rate was 100 %(45/45). In operation treatment group the cure rate was 98.2 %(112/114), the mortality rate was 1.8 %(2/114), 1 case died of hemorrhage after operation and 1 case died of ARDS. Five patients with postoperative complications were cured, including hepatic abscess in 2 cases, biliary fistula in 2 cases, and hemorrhage after operation in 1 case. Conclusions B-ultrasound is the method of choice for diagnosis of liver trauma, and CT can be used if conditions permit. Cases of lives truma of stages Ⅰ and Ⅱ and some cases of stage Ⅲ that have stable hemodynamics, can receive nonoperative treatment under close observation. Some cases of stage Ⅱ, most cases of stage Ⅲ and all cases of stages Ⅳ to Ⅵ injury should preferably undergo surgical treatment.
ABSTRACT
Objective To explore the feasibility and indications of non-operative management for blunt liver injury.Methods The clinical data of 109 patients with blunt liver injury treated in recent 5 years were reviewed retrospectively.Results Among 109 cases, 35 were treated with nonoperation and 33(94.3 %) were cured; there were 3 cases(9.1 %) with complications among the 33 cases who were cured. The mean amount of blood transfusion, hospitalization days and expenses were (2.5?0.8)U,(13.2?1.3)d and (5 250?335) yuan, respectively. Seventy-four cases were treated with operation and 68(91.2 %)were cured, there were 14 cases (20.6 %) with complications among the 68 cases who were cured. The mean amount of blood transfusion,number of hospitalization days and expenses were (8.4?1.1)U,(15.4?0.9)d and (13 550?805) yuan,respectively.The mean amount of blood transfusion and hospitalization expenses of nonoperative group were lower than those of operative group (P
ABSTRACT
Objective To investigate the clinical significance and indications of non operative management for liver trauma(LT). Methods The clinical date of 66 cases of LT treated by non operation from November 1987 to November 2000 were retrospectively analyzed. Results There were 38 cases (57.6%) in class I of LT, 18(27.3%) in class II, 10(15.2%) in class III in this series. 64 cases were cured (97.0%), including 2 cases combined with active bleeding were converted to operation and curred; 2 cases (3.0%) died of combining with severe brain damag. 4 cases(6.1%) complicated with liver abscess were cured by non operative treatment. Conclusions The non operative management is suitable for all cases of class I, II and partial cases of class III of LT. The observation of blood dynamics is most important, and B-type ultrasonography is also imporant, The operation would be done if the case is combined with massive active bleeding.
ABSTRACT
Objective To investigate the effects of placing medical collagen sponge on the wound surface for severe rupture of liver.Methods In 132 patients with severe hepatic trauma , 68 cases were randomly enrolled in collgan spong treatment group, in which the hepatic wound was treated with collagen sponge,while the 64cases in control group were treated with commonly used gelatin sponge. Results The therapeutic results of collagan spong group were better than those of control group in the hemostatic time [(19.65?1.28)min vs (34.3?1.2)min], hemorrhagic volume [(301.57?56.8)mL vs (642.3?61.8)mL], abdominal cavity drainage volume[(380.45?12.34)mL vs (693.2?219.4)mL], recovery time of hepatic tissue [(30.30?6.42)d vs (62.1?7.2)d], postoperation complications (re-bleeding , and hepatobiliary leakage) [11.5% and 3.0% vs 6.3% and 9.5%], and hospital time stay [(24.01?4.89)d vs (35.8?5.9)d] (all with P