水囊肝周填塞和传统纱布填塞在损伤控制性手术治疗严重肝外伤中的疗效对比

摘要

To investigate how to improve the success rate of rescue of severe liver trauma. Method:The clinical data of 25 patients with severe liver trauma who were treated with damage control surgery in our hospital from July 2003 to March 2014 were retrospective analyzed,according to the different packing method,they were divided into the traditional gauze packing group for 14 cases and the water sac perihepatic packing group for 11 cases.The rebleeding rate,mortality,reoperation rate and complications of the two groups were observed and compared.Result:The mortality,rebleeding rate,reoperation rate and incidence of complications in the water sac perihepatic packing group were significantly lower than those in the traditional gauze packing group,the differences were statistically significant (P<0.05).Conclusion:When severe liver trauma with damage control surgery,the self-made water bursa of peripheral hepatic tamping compression hemostasis effect is remarkable,the operation is simple,is a more practical method of bleeding,is worthy of clinical promotion.%目的：探讨如何提高严重肝外伤的抢救成功率。方法：回顾性分析2003年7月-2014年3月在本院诊治的采用损伤控制性手术的25例严重肝外伤的临床资料，根据不同的填塞方法将所有患者分成传统纱布填塞组14例和水囊肝周填塞组11例，观察比较两组患者的死亡率、再次出血率、再次手术率和并发症等差异。结果：水囊肝周填塞组的死亡率、再出血率、再手术率及并发症发生率均明显低于传统纱布填塞组，差异均有统计学意义（P<0.05）。结论：严重肝外伤采用损伤控制性手术治疗时，自制水囊肝周填塞压迫止血效果显著，操作简单，是一种较为实用的止血方法，值得临床推广。