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目的探讨医源性下腔静脉损伤的预防和紧急处理。方法回顾性分析7例医源性下腔静脉损伤,原发病为右肾上腺肿瘤1例,右肾肿瘤3例,右脓肾1例,右上腹膜后肿瘤1例,胰头癌1例。损伤后致大出血立即压迫止血,原右腰部切口者重新改行腹部切口,入腹后用手向右推挤下腔静脉立即止血,吸净积血看清腔静脉破口,取辛氏钳夹闭破口,以3-0丝线或聚丙烯不吸收线连续缝合损伤处。结果本组7例中1例抢救不力,致出血性休克死亡,6例止血效果良好,其他合并伤均积极治疗获愈,仅1例双下肢轻度浮肿。结论医源性下腔静脉损伤只要紧急抢救方法得当均可获得成功。术中仔细操作,此种损伤是完全可预防的。
Objective To investigate the prevention and emergency treatment of iatrogenic inferior vena cava injury. Methods Seventeen cases of iatrogenic inferior vena cava were retrospectively analyzed. The primary disease was one case of right adrenal tumor, 3 cases of right kidney tumor, 1 case of right pus kidney, 1 case of right upper retroperitoneal tumor and 1 case of pancreatic head cancer. Immediately after injury, hemorrhage caused by massive bleeding hemostasis, the original right waist incision who re-diverted abdominal incision, into the abdomen by hand to the right to push the inferior vena cava immediately stop bleeding, suction net hemorrhage to see the vena cava break, take Xin clamp clamp Break, to 3-0 silk or polypropylene non-absorption line continuous suture injury. Results One patient in 7 cases was ineffective in salvage and died of hemorrhagic shock. The hemostatic effect was good in 6 cases. All the other combined injuries were cured actively. Only 1 case had slight edema of both lower extremities. Conclusions iatrogenic inferior vena cava lesions can be successfully treated only if they are properly salvaged. Careful operation during surgery, such injuries are completely preventable.