肝损伤临床分级及治疗方法的探讨

肝损伤临床分级及治疗方法得探讨 陈中伟 马晓 陈伟 黄存「摘要」 目得：探讨肝损伤临床分级及两种治疗方法得比较。方法：将我院近5 年收治得闭合性肝损伤患者按治疗方法分为手术组 86 例及非手术组 110 例。对比两组患者住院天数、年龄等一般指标，同时监测两组患者入院时、治疗第3 天、治疗第 7 天及出院时血色素(HGB)、白细胞(WBC)、血小板(PLT)、直接胆红素(DBIL)、间接胆红素(IBIL)、天门冬氨酸转移酶(AST)、丙氨酸氨基转移酶(ALT)得动态变化。结果：两组患者年龄比较无明显差异(p﹥0、05)，住院天数非手术组较手术组缩短(p﹤0、05)。各项指标上：DBIL、HGB 两组比较在四个时间段均有统计学意义(p﹤0、05)；WBC、AST 在治疗第 7 天与出院时两组比较有统计学意义(p﹤0、05)；PLT、IBIL、ALT 两组比较在四个时间段均无明显差异(p﹥0、05)。结论：正确把握治疗原则，把握手术适应症。在血流动力学稳定及严密监测情况下，尽可能选择非手术治疗。「关键词」 肝损伤；分级；非手术治疗Objective:To discuss clinic grading and contrast of two kinds of treatment about the hepatic trauma；Methods: Choose patients with closed hepatic trauma were hospitalized in our hospital in past five years,which were divided into operative group of 86 cases and nonoperative group of 110 cases according to treatment、 To compare the days in hospital and the age et,Before the treatment and 3th,7th day after the treatment and the time live hospital,HGB,WBC,PLT,IBIL,DBIL,AST,ALT in two groups were recorded and analyzed ；Results: There have no obvious difference in two groups about age(p﹥0 、 05),the nonoperative group was shorter than the operative group about days in hospital(p﹤0、05)、 there have difference in two groups of HGB and DBIL in the four time(p﹤0、05)、 there have difference in two groups of WBC and AST in 7th day after the treatment and the time live hospital(p﹤0、05)、 there have no difference in two groups of PLT 、 IBIL 、 ALT in the four time(p﹥0 、 05) ；Conclusion:W...