The analysis about the clinical prognosis of 90 patients with blunt hepatic injuries after surgieal management

Abstract

Objective To analysis the risk factors determining operativc mortality in blunt hepatic injuries. Methods This was a retrospective case study of 90 patients with blunt hepatic injuries managed operatively. Statistical analysis was performed using univariate analysis logistic regression. Results The overall operative mortality was 16% ,and 14 patients died with 1 in grade Ⅲ ,4 in grade Ⅳ ,9 in grade Vand 11 cases in liver related cause( 12% ) and 3 in not liver related cause(3% ). Univariate comparison of clinical factors between nonsurvivors and survivors in grade Ⅳ- Ⅴ indicated: systolic blood pressure, pulse, injury severity sore ( ISS), total intraoperative blood loss and hospital days were significant between two groups. Comparison of surgical treatment of severe hepatic injuries indicated: relative hazard ratio (HR) of debridement hepatectomy was 0. 73, and the operative mortality was low. HR of anatomical hepatectomy and venorrhaphy of major hepatic vein and retrohepatic vena cava were 1.32 and 1.52 respectively,and the operative mortality was high, Conclusion Expeditious resuscitation and appropriate surgical management, to control operative blood loss, are helpful to reduce operative mortality in patients with blunt hepatic trauma. Key words: Blunt hepatic injuries; Surgical management; Operative mortality