脏器破裂（Organ rupture）.docVIP

脏器破裂（Organ rupture） Splenic rupture Stage 4 grading method for splenic injury Class I: splenic subcapsular rupture or by membrane and essence of mild injury, intraoperative splenic laceration length is less than 5, less than 1 cm depth Grade II: the length of laceration of spleen was 5 and the depth was 1 cm, but the splenic hilum was not involved or the splenic segment vessels were involved Stage III: rupture of spleen, laceration of splenic hilum or spleen, or vascular involvement of splenic lobe Stage 4: extensive rupture of the spleen or involvement of the splenic pedicle and splenic arteriovenous trunk Treatment principle: save life first, keep spleen second Nonoperative management indication: Transient shock without shock or correction Imaging examination showed that splenic laceration was relatively limited and superficial There were no other abdominal organ injuries Operation indication: Continuous bleeding was observed (48 hours of domestic blood transfusion, 1200ml) The combination has other organ damage Operation mode: Spleen preserving surgery Splenectomy: rupture of splenic center, tear of splenic hilum or massive inactivation of tissue; advanced age; severe multiple injuries; pathological spleen Splenic transplantation: the spleen can be cut into thin slices or small pieces into the great omental bursa, and the autograft is transplanted Hepatic rupture Huang Zhiqiang classification of hepatic trauma Class 1: laceration depth is not more than 3cm Stage II: the 2~3 branch of the hepatic artery, portal vein, and hepatic duct Grade III or central injury: injury of hepatic artery, portal vein, hepatic duct or its branch injury surgical treatment Basic requirements: debridement, hemostasis and elimination of bile leak to establish the exact and effective drainage Treatment principle: The anger is hurt and non firearm injuries involving hollow organs should be surgical treatment Stab and blunt injury mainly according to the general condition of the wounded t