摘要
目的分析针对创伤性肝脏破裂患者的最优手术治疗方案以及临床效果。方法方便选取该院2014年9月—2017年11月诊治的创伤性肝脏破裂患者48例作为此次的研究样本,以随机数字法分组为观察组、对照组。对照组患者行常规手术治疗,观察组患者行损伤控制性手术治疗,对比两组患者的临床疗效及相关手术指标。结果观察组患者抢救成功率为95.83%,而对照组患者中抢救成功率是87.50%(χ^2=5.1971,P=0.0226<0.05);观察组患者在手术用时、术中出血量、体温恢复时间、住院时间PT和APTT恢复时间、ISS评分以及乳酸清除时间分别为(138.95±16.71)min、(754.16±51.24)L、(24.56±4.16)d,(7.86±1.54)h、(13.26±2.14)h、(14.87±5.62)h、(10.18±4.86)h、(40.13±3.52)分等围术期指标方面均较对照组患者明显更优(t=4.621、3.174、5.637,4.569、5.617、2.361、4.698、3.267,P<0.05);观察组患者术后出血2例(8.33%)、败血症0例(0.00%)、肺部感染1例(4.17%)、胆道感染1例(4.17%)以及肝膈下脓肿2例(8.33%)等并发症率均较对照组的明显更低(χ^2=3.219、3.207、2.239、2.482、3.163,P<0.05)。结论在创伤性肝脏破裂患者治疗中采取损伤控制性手术治疗能够进一步提升患者抢救成功率,有助于促进患者术后恢复,同时能够降低术后并发症风险,损伤控制性手术治疗方案值得在创伤性肝脏破裂患者治疗中应用并推广。
Objective To analyze the optimal surgical treatment and clinical outcomes for patients with traumatic liver rupture. Methods Forty-eight patients with traumatic hepatic rupture diagnosed in our hospital from September 2014 to November 2017 were convenient divided into observation group and control group. Patients in the control group underwent routine surgery. The patients in the observation group underwent controlled surgical treatment of the injury. The clinical efficacy and related surgical indexes were compared between the two groups. Results The success rate of rescue in the observation group was 95.83%, while the success rate in the control group was 87.50%(χ^2=5.197 1, P=0.022 6<0.05). The patients in the observation group had the time of surgery, intraoperative blood loss and body temperature recovery time. The hospitalization time PT and APTT recovery time, ISS score and lactate clearance time were (138.95±16.71)min,(754.16±51.24)mL,(24.56±4.16)d,(7.86±1.54)h,(13.26±2.14)h,(14.87±5.62)h,(10.18±4.86)h,(40.13±3.52)points, etc. The index of the operation was significantly better than that of the control group (t=4.621, 3.174, 5.637, 4.569, 5.617, 2.361, 4.698, 3.267, P<0.05);the postoperative bleeding in the observation group was 2 cases(8.33%), sepsis 0 cases(0.00%), the complication rates of pulmonary infection 1 cases(4.17%), biliary infection 1 cases(4.17%), and subhepatic abscess 2 cases(8.33%) were significantly lower than those of the control group (χ^2=3.219, 3.207, 2.239, 2.482, 3.163, P<0.05). Conclusion Injury controlled surgical treatment in patients with traumatic hepatic rupture can further improve the success rate of patients, help to promote postoperative recovery, and reduce the risk of postoperative complications. The controlled surgical treatment plan is worthy of It is applied and promoted in the treatment of patients with traumatic liver rupture.
作者
赵锡文
ZHAO Xi-wen(Wenshan People's Hospital of Yunnan Province,Wenshan,Yunnan Province,663000 China)
出处
《中外医疗》
2019年第11期28-30,共3页
China & Foreign Medical Treatment
关键词
肝脏破裂
创伤
手术
效果
Liver rupture
Trauma
Surgery
Effect
