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asbryobvrz · Wysłany: Sob 20:15, 19 Mar 2011

44 cases of severe liver injury diagnosis and treatment of

Signs easily concealed. With brain trauma, because of poor response patients,[link widoczny dla zalogowanych], the abdomen is not easy detection of positive signs, this time to make early paracentesis. Puncture to the attention of: ① the injured abdominal wall thickness, should be avoided and not too short needle into the abdominal cavity. @ Careful not to penetrate the abdominal wall hematoma caused by false positives. ③ the best side of the needle into the side of local anesthetic until the abdominal cavity, to avoid clogging puncture needle muscle fiber fragments. ④ a right lower quadrant puncture is not successful, change the location to wear, otherwise too much liquid may be due to the small intestine and abdominal omental plug float needle. ⑤ attention to puncture the color of blood, dripping on the gauze can be observed, such as the color of bile stained liver rupture should be considered. . 2.2 The rapid diagnosis of early post-treatment should be complementary and to maintain effective blood volume of emergency,[link widoczny dla zalogowanych], if not by active expansion of the shock to correct, that is, to restore blood volume at the same time for surgery. If the merger of Xuzhou Medical College of blood Ac1 ~ AAcADEMIAEME1) JcINAEXUZHOU1997.17 (4) pneumothorax,[link widoczny dla zalogowanych], should be used to closed thoracic drainage. To avoid anesthesia and intubation caused by tension pneumothorax. Such as head injury coma, brain herniation and other symptoms. Should also be head and abdominal surgery. Into the abdomen soon after the exhaustion of hemoperitoneum, or other gastrointestinal contents, and then probe the liver rupture were to take a variety of hemostatic methods: ① clean up after liver lifeless, or gelatin sponge filled mattress after pedicled omental packing suture. 1l, and the group were l2 cases. Bleeding wound must be thoroughly, otherwise easy to form intrahepatic hematoma. ② If the injury serious. Suture was extremely difficult or deep stellate-shaped fracture, comminuted fracture,[link widoczny dla zalogowanych], should be irregular hepatectomy. L5 patients in this group. ③ liver near the rear of the second activity of hilar bleeding, often associated with inferior vena cava or hepatic vein tear. Must be decisive free right liver. Repair under direct vision as far as possible. 2 patients in this group also broken the liver resection revealed the inferior vena cava, repairing cracks cured. 2 down no time dealing with death. @ Number of stellate-shaped fracture, the location closer to the second hepatic portal, and primary hospital conditions do not permit, the available packing gauze pad to stop bleeding. This method has now been recognized as the treatment of severe liver injury, a life-saving measure for a q spin I2]. Section 2 of the pad down yarn packing to stop bleeding after cure. Other organs such as the combined fleet cavity damage. Should also be given to repair or excision. 2.3 Treatment of severe liver injury after liver cells are destroyed because of massive and shock induced liver hypoperfusion, could easily lead to liver failure, so we should focus on protection of liver function after surgery. The group became ill and have different levels of transaminase increased. Individual jaundice due to liver given early treatment, that is oxygen, amount of albumin,[link widoczny dla zalogowanych], branched-chain amino acids, vitamins and energy mixture. The patient gradually improved and cured.