关键词: 外伤性肝破裂, 损伤控制性手术, 并发症, 生存率

Abstract: Objective The aim of this study was to investigate the survival of patients with severe traumatic hepatic rupture (STHR) after damage control surgery (DCS). Methods The clinical data of 66 patients with STHR were retrospectively analyzed in our hospital between April 17 and January 2019, and 32 patients received conventional surgery and 34 received DCS. The survival rates in short-term follow-up were compared between the two groups. Results The surgery time in the DCS group was (141.0±10.7) min, significantly shorter than that [(185.2±15.8) min, P<0.05] in the conventional surgery group, the intraoperative blood loss in the DCS group was (754.6±52.3) mL, significantly less than [(1185.7±104.6) mL, P<0.05] in the conventional surgery group, the injury severity score (ISS) in the DCS group was (39.9±4.4), significantly lower than [(46.8±5.0), P<0.05] in the conventional surgery group, and the shock correction time in the DCS group was (6.2±1.1) h, significantly shorter than [(9.1±3.4) h, P<0.05] in the conventional surgery group;the parameters monitored after operation, such aspH [(7.4±1.3) vs. (7.4±0.8)], prothrombin time [(12.9±2.3) s vs. (13.0±2.8) s] and APTT [(37.1±3.2) s vs. (40.3±7.5)s] were not significantly different (P>0.05) in the two groups; the incidences of post-operational complications, such as subdiaphragmatic abscess, biliary fistula, abdominal infection and stress peptic ulcer in DCS group was 20.6%, significantly lower than 62.5%(P<0.05) in the conventional operation group; the survival rate inDCS group was 88.2%, significantly higher than 71.9% in the conventional surgery group (P<0.05). Conclusion The application of DCS might significantly improve the perioperative indexes of patients with severe traumatic liver rupture, which is related to the less postoperative complications.

Key words: Traumatic hepatic rupture, Damage control surgery, Conventional surgery, ComplicationS, Survival rate