頁籤選單縮合
題 名 | Liver Trauma=肝臟外傷 |
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作 者 | 陳維藩; 劉文彬; 林天祐; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 1:3 民57.09 |
頁 次 | 頁229-240 |
關鍵詞 | |
語 文 | 中文(Chinese) |
中文摘要 | 肝臟外傷在19世紀末葉以前均用保守療法治療。但自Burckhardt於1887年用手術療法成功的治療肝臟外傷以來漸漸被人廣範的採用。其死亡率則由初期之66.3%降低至最近之一成左右。 本文就64例住院臺大醫院外科(自1958年元月至1968年二月)之肝臟外傷病例作一分析檢討。在臺灣穿通性肝臟外傷多由刀傷引起,而非穿通性外傷則多起因於交通意外。兩者都以中年男性占大多數,這點與男性多戶外之活動有關。大部份病人之肝臟出血可用縫合圓滿達成,但有極少部份(6.2%)。則須更進一步切除受損之肝臟才能止血。此等縫合止血,若深度間隔不恰當,則可能導至肝內囊腫及Hemobilia之形成,應慎重考慮。合併症以細菌感染為最多,故手術時除止血外充份引流亦為重要措施之一。嚴重之肝臟損傷病人肝外膽道引流可減少膽汁外溢及肝內囊腫,並可早日診斷Hemobilia。手術中之輸血應由上肢輸入,免因下腔靜脉等大血管之合併損傷而影響輸血之效果。肝臟外傷常合併有其他臟器之損傷。死亡病例9例中6例卽因其他器官之傷害致死,真正死於肝臟外傷者僅3例約5%而已。 |
英文摘要 | 1. Sixty four cases of liver injury, including 29 penetrating and 35 blunt injury, were reviewed. Death occurred in 9 cases. Three deaths were directly related to the liver injury, while the other six deaths were due to concomitant severe injury. 2. Hemostasis was achieved successfully with sutures in most of the cases. In the severely injured cases and in the case complicated with hemobilia, resection was performed with "Finger Fracture Technic". 3. Intra-hepatic traumatic cyst with hemobilia was noted in two among the penetrating injury. The cause was due to im-proper suture technic in one and the other never recieved operative repair of the liver. 4. In application of the sutures to repair and control bleeding from liver injury, inadequate depth of the sutures would result in traumatic cyst formation and hemobilia. 5. Intra venous blood transfusions should be given through upper extremities rather than lower extremities in the severe abdominal injury. 6. Complications can be reduced with adequate peritoneal drainage, and perhaps extrahepatic biliary drainage in case of severely injured liver, particulary the latter would reduce the chance of infection, bile peritonitis, and provide prompt detection of hemobilia. |
本系統中英文摘要資訊取自各篇刊載內容。