102例闭合性肝脾破裂保守治疗的护理体会

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102例闭合性肝脾破裂保守治疗的护理体会作者：白俊红

来源：《中国实用医药》2010年第08期

【摘要】目的回顾性分析102例接受保守治疗闭合性肝脾破裂患者的临床资料,总结闭合性肝脾破裂保守治疗的护理体会。方法严格选择具适应证的患者,严密观察患者生命体征、腹部变化、输液量及速度、出入液量、药物的使用情况及效果,同时配合精心的生活护理。结果102例肝脾破裂患者经保守治疗,腹腔积血全吸收,73例肝脾损伤完全恢复,29例肝脾损伤基本恢复,残留少许直径 2~3 cm左右低密度区或机化灶,随访分别于1~3个月基本消失。结论保守治

疗肝脾破裂是安全有效的,对于条件适合的患者可作为首选治疗方案在临床应用。

【关键词】闭合性肝脾破裂;保守治疗;护理体会

【Abstract】 Objective Retrospective analysis of 102 cases received conservative treatment of blunt liver and spleen rupture in patients with clinical data, summed up the conservative treatment of blunt liver and spleen rupture of Nursing.Methods The strict selection of patients with indication to closely observe the patient's vital signs, abdominal changes, infusion volume and speed of access to fluid volume, drug use and effect of living at the same time with the elaborate care.Results 102 cases of liver and spleen rupture in patients with conservative treatment, Hemoperitoneum full absorption of 73 cases of liver and spleen injuries fully restored, and 29 cases of liver and spleen damage the basic recovery, residual 2~3 cm in diameter around a little low-density area or a computerized stove,

follow-up 1~3 months, respectively, disappeared.Conclusion Conservative treatment of splenic rupture is a safe and effective for patients with suitable conditions can be used as the preferred treatment programs in the clinical application.

【Key words】 Blunt liver and spleen rupture; conservative treatment; nursing experience

外伤性肝脾破裂是普外科常见急腹症,居腹腔脏器实质性损伤之首,传统治疗方法常采用手术方式切除破裂的肝脾。但随着人们对肝脾损伤认识的提高和B型超声、CT等影像学技术水平的提高,对闭合性腹部损伤部分肝脾破裂患者用非手术治疗而治愈[1]。我院自1995年8月至2009年8月对102例闭合性肝脾破裂患者在坚持抢救生命第一,保留脏器第二的原则下行保守治疗,通过密切的病情观察、合理的治疗措施及精心的身心护理,收到良好的效果。现将护理体会报告如下。

1 临床资料

1.1 一般资料本组102例,男 59例,女 43例。年龄6~70岁,平均(35.2±3.4)岁。伤后20

min~36 h就诊,平均 5 h,均为腹部闭合肝破裂。致伤原因有车祸伤、坠落伤、挤压伤等,其中,肝