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頁籤選單縮合
題名 | Atrial Caval Shunt in the Management of Juxtahepatic Venous Injuries=以心房下腔靜脈分流術治療肝後下腔靜脈外傷 |
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作者 | 方禎鋒; 陳瑞杰; 王植熙; 陳敏夫; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 26:6 民82.11-12 |
頁次 | 頁2057-2062 |
分類號 | 416.14 |
關鍵詞 | 心房下腔靜脈分流術; 肝; 後下腔靜脈外傷; Atrial caval shunt; Juxtahepatic venous injury; |
語文 | 英文(English) |
中文摘要 | 長庚紀念醫院在1991年7月至1992年6月一年間,使用心房下腔靜脈分流術治療6例肝後下腔靜脈外傷之病患。六例病患中有一例為槍傷,其餘五例為腹部鈍傷。全部6例病患在到達本院急診時都呈現休克狀態。有一例病患先在地方醫院接受手術經18小時後才轉至本院,其餘五例平均到院前延遲時間為80分鐘。除肝臟及下腔靜脈外傷外,有五例尚合併其他傷害,其外傷嚴重度指數為25-66。有四例病患在手術中因嚴重休克及出血而死亡。有二例經由心房下腔靜脈分流術成功的修補下腔靜脈裂傷。其中一例在術後三天因長時間休克所併發的多處器官系統衰竭而死亡,另一例則康復且未發生併發症。肝後下腔靜外傷是死亡率很高的傷害。積極的初步急救,正確的檢傷分類及快速轉送適當的醫院是改善預後的最重要因素。心房下腔靜脈分流術對於早期診斷手術之病患可以有效的達到止血的目的。 |
英文摘要 | From July 1, 1991 through June 30, 1992, six patients with major juxtahepatic venous injuries were treated with atrial caval shunts. One patient had suffered a gunshot injury; the other five were victims of blunt trauma. All six patients were in shock state on admission, and five of the six had associated injuries, with injury severity scores ranging from 25 to 66. Major hepatic resection was required in five patients. Four patients died intraoperatively from exanguination. In two cases, the atrial caval shount effectively arrested the hemorrhage, allowing for successful surgical repair of the venous injuries. One of these two patients died three days postoperatively from multiple organ system failure. The final patient survived, and was subsequently discharged from the hospital without complications. Major juxtahepatic venous injuries are highly lethal. An atrial caval shunt will permit the salvage of some patients in whom other methods are not possible or not effective. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。