Splenectomy bleeding _9114 -

nrzxfquxq

,[link widoczny dla zalogowanych]
Splenectomy for bleeding

Signs of blood, circulatory instability should be integrated to create rear parts to catch surgical exploration. Real barrier rupture or rupture of the spleen associated with extensive E Yu Wei slightly better with multiple organ injuries were severe, unstable blood pressure, joint units and spleen surgery who can not achieve effective hemostasis, shall be taken to splenectomy. Mild spleen injury,[link widoczny dla zalogowanych], multiple organ damage may not consider the line spleen-preserving surgery. However, wound closure splenic injury should be observed for at least l5 minutes, blood pressure rise, spleen sewing station at no. Bleeding signs of water before hand that success. . {A} R thousand jack. Man f. ], Blood loss during liver resection mouth f Bu 』. Shandong subsidiary Jade Imperial College Medical School (250012) Zhang Guang. tf. One hundred and eleven liver resection surgery Tada bleeding injury due to the great vessels. Familiar with the anatomy of the liver,[link widoczny dla zalogowanych], caused by operation Programme surgery, bleeding can be, to prevent and avoid climbing. '1 Bearing in mind that the first branch of portal vein injury bleeding hepatectomy half careless handling can tear the first nine-hepatic portal vein caused by bleeding. Large tumors, close to the first merger Bin Ding portal hypertension, the Ministry of rich blood supply of liver Ding, Ding pretty solid liver anatomy is difficult, but also super easy to lead resection of bleeding in the bladder series, we bypass the liver-second routine with a preset duodenum with the blocked zone, and India can be blocked if necessary, find the bleeding point or first-line hemostatic patch and then cut hepatic portal blocking can often avoid surgery bleeding. With obvious cirrhosis, portal in order to avoid blocking the function of sweat caused by excavation damage after surgery, can also be dissected hepatic artery, hepatic artery ligation of the main branch of the affected side, the use of portal vein occlusion 1996 @ build dependents 31tJJ] lt East 『down without cutting into the selective occlusion Ⅱ 1. 2 hepatic vein injury after hepatic veins in the liver bare area liver』 Second, there are three main branch of the inferior vena cava below the diaphragm directly to exchange (where said second liver door), the first cut right coronary ligament is called hepatic vein can be seen I [at the inferior vena cava. In order to prevent hepatic venous injury,[link widoczny dla zalogowanych], cut the liver in hepatic vein before ligation; right liver resection, the right leaf clover after liver resection and right except when the Secretary should cut off the right hepatic vein ligated right coronary ligament to the liver bare area Yes, carefully cut the top F} coronal Bangdai hepatic venous can see,[link widoczny dla zalogowanych], with a large curved needle thread depth 7, the suture of liver parenchyma, to avoid tearing in the process of cutting about liver vein cause bleeding such as tumor large exposure is not good, and no pre-ligation of right hepatic vein, the liver is pulled down too easy to tear to the left, the right hepatic vein. Ligation of right hepatic vein ligation is not strong bore Results slippage, or may also cause bleeding. One such bleeding occurs, the folder must not use forceps radium, the inferior vena cava to avoid damage. Should be left index finger immediately after diaphragmatic thoracic extension and forward the top eight, and then thumb back pressure at the right hepatic vein bleeding, blood in net absorption after the ligation method used to stop bleeding. In the implementation of left lateral hepatic lobectomy and left, the same should be cut prior to ligation of left hepatic vein, to prevent damage caused by the venous bleeding. Looking for a sign of the left hepatic vein (hepatic vein vessels up and down slightly on the left diaphragmatic surface of liver depression right in the diaphragmatic surface of liver falciform ligament attachment points directly on the extension line), or separation, can be seen directly under the left hepatic vein into the vena cava Department, Bank of liver resection left a large curved needle in the liver can be the face of potential left hepatic vein phrenic depth icm of the suture within the hepatic parenchyma. Left lobe in the right liver resection or injury in order to avoid hepatic vein and liver resection should be left in the split liver, half of the prepared liver resection back 1cm, so reservations may be slightly more liver tissue, but also retained hepatic vein. 3 bearing in mind that hepatic vein and inferior vena cava snail damage Xu collection of short vein and right caudate lobe posterior lobe of the change thy blood, liver and muscle the right side straight for the import of inferior vena cava (issued for the third liver | 1), their number is uncertain. Line right liver resection (especially lung tumor in the right posterior lobe), the liver due to excessive traction turned to the left, easily torn or ripped short hepatic veins and inferior vena cava, causing bleeding. Therefore, in the process of cutting the liver do not over-stretch the liver, cut liver tissue close to the inferior vena cava and inferior vena cava should be measures to bottom-right side of the wall will be short hepatic veins and hepatic side edge of the central bank cut ligation. Once the bleeding here, in the case of removal of the tumor revealed not bad, very difficult to stop bleeding, gauze pads available at this time, after temporarily filling pressure parked liver bleeding, and rapid blood transfusion, as soon as possible and then block by block Ke addition to the tumor out gauze pads, one side Ai net accumulation of blood, find the break at the side of ligation of bleeding by clamping the inferior vena cava, if there are tears, vascular clamping can stay injury-free wall rupture of the Ministry of superior vena cava, with 4-0 or 5-0 nylon suture vein . 4 liver section If bleeding during liver resection in liver vessels pull off coarse, its ends can be retracted into the liver parenchyma bleeding caused by liver slice. We first electric knife when cutting the liver capsule to open the liver, liver parenchyma and then handle separation, met with a vascular clamp pipe clamp cut ligation. Breaking camp, such as blood should be blocked secret portal to control the bleeding, find the bleeding point suture with 8 characters. Elastic tie should be appropriate. Oozing with hot salt water a few indistinct

				fora.pl - załóż własne forum dyskusyjne za darmo Powered by phpBB © 2001, 2002 phpBB Group Avalanche style by What Is Real © 2004