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纱布填塞用于腹部手术难以控制的大出血

         

摘要

目的 探讨纱布填塞法用于腹部手术难以控制的大出血的价值.方法 对15例腹部手术中大出血病人采用纱布填塞法.其中腹膜后肿瘤1例,创伤性肝破裂2例,肝癌行肝右三叶切除肝创面渗血1例,门静脉高压症行断流术食管旁、脾窝渗血3例,急性肝功能衰竭行原位肝移植术中肾上腺区域、肝裸区腔静脉旁后腹膜创面广泛渗血8例.结果 15例术后腹腔引流量均逐日减少,填塞纱条术后5~10 d内拔出,2例因感染继发多器官衰竭死亡.结论 对于腹部手术难以控制的大出血,纱布填塞止血方法仍不失为一项重要的、简单有效的止血手段.%Objective To explore the value of gauze packing for uncontrolled bleeding of abdominal surgery. Methods Fifteen cases of massive haemorrhage during abdominal surgery were treated with gauze packing method. Among them, there was 1 case of retroperitoneal tumor, 2 cases of traumatic rupture of the liver, 1 case of liver wound oozing blood in hepatocellular carcinoma after resection of hepatic right 3 lobes,3 cases of paraesophageal,splenic fossa oozing blood in portal hypertension after devascularization,8 cases of retroperitoneal wound bleeding extensively in the adrenal region and the bare area of the liver next to inferior vena cava in acute liver failure after orthotopic liver transplantation. Results In 15 cases, postoperative peritoneal drainage volume was decreased daily. The packed gauze was pulled out 5-10 days after operation. There were 2 cases of multiple organ failure to death due to secondary infection. Conclusion For uncontrolled massive haemorrhage in abdominal surgery, gauze packing method was still a major means of simple and effective hemostasis.

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