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題 名 | Hepatic Artery Ligation and Peri-Hepatic Packing in the Management of Major Liver Trauma: Case Reports=肝動脈結紮及肝外墊褥法於嚴重肝臟外傷之應用:病例報告 |
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作 者 | 吳汐淇; 陳豐基; 高義智; 陳瑞杰; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 33:1 民89.01-02 |
頁 次 | 頁30-35 |
分類號 | 416.246 |
關鍵詞 | 肝動脈結紮; 肝外墊褥法; 肝臟外傷; Hepatic artery ligation; HAL; Peri-hepatic packing; |
語 文 | 英文(English) |
中文摘要 | 肝臟為人體腹內最易受傷之器官,肝臟外傷可經常於急診室發現,尤其在於嚴重之車禍事故或撞擊後,大部分之肝臟外傷(80-90%)多為第一級~第二級,僅需密切觀察及支持性療法即可,另外的10% (第三級~第五級)則不易處理。 處理肝臟外傷困難之處在於止血,許多傳統的方法各有其不同之成功率,目前被廣為接受的方法為肝外墊褥止血,然而對於施行肝外墊褥壓迫後,尚仍無法有效止血的肝臟外傷則令人頭痛。 本文報告三例嚴重肝外傷併出血性休克之病人,在剖腹檢查時由於單獨肝外墊褥壓迫及Pringle手法仍持續出血,因此吾人施以肝動脈結 紮作為輔助療法,經過48-72小時後取出墊褥,已有效止血,三名病人皆存活,術後追蹤肝臟功能亦無明顯異常,在此提出心得與經驗報告。 |
英文摘要 | Major hepatic trauma is often encountered in the emergent room after severe traffic accidents or impacting injuries. However, the liver is the most vulnerable intra-abdominal organ to trauma. Most liver injuries (80~90%) are minor (Grade I~II) which require only close observation and supportive treatment, the remaining 10% (GrIII~V) are major injuries and uneasy to handle. Controlling hemorrhage from wounds of the liver is difficult, many traditional methods of achieving hemostasis have variable success rates. We present our experiences in three cases of using hepatic artery ligation (HAL) as an adjuvant method for those that bleeding were controlled initially by peri-hepatic packing and Pringle maneuver but with persistent hemorrhage after releasing portal triad occlusion. Successful hemostasis were obtained 48 ~ 72 hours after removal of packs, no significant hepatic function deficits observed except one patient developed intra-abdominal abscess. All patients survived. |
本系統中英文摘要資訊取自各篇刊載內容。