近20年来，肝脏损伤的处理有很大发展和改变，主要是CT扫描的进步带来早期精确的诊断，以及血流动力学稳定的患者更多地采用非手术治疗。选择性肝动脉造影栓塞是主要的非手术治疗手段。与此同时，对需要立即手术的患者的认识和判断变得格外重要。事实上，大多数Ⅳ～Ⅴ级肝脏损伤仍需手术治疗，而且伴有肝后静脉损伤的患者在处理上仍面临巨大挑战，且维持较高的死亡率。因此，处理这类损伤的手术技术必须寻求发展和突破。%Management of liver trauma has changed and developed in the last two decades with the develop-ment of CT scan and non-operative treatment of hemodynamically stable patients.Selective hepatic arteriography is a main non-operative treatment method.Meanwhile,recognition of the patient who should proceed to immediate lap-arotomy is of utmost importance.In fact,most of patients with hepatic injury of grade Ⅳ-Ⅴ still require operative interventions.Furthermore,dealing with those patients with retrohepatic venous injury faces a great challenge and has a high mortality.Therefore,progress and breakthrough of surgical techniques for such cases are necessary.
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