Treatment of 46 cases of head injury and liver injury

Objective To summarize the experiences and lesson in treatment of 46 cases of head injury and liver injury and determine the risk factors for death.Methods From 1993 to 1999,46 patients with head injury and liver injury were treated in our hospital.They were divided into 3 groups according to their clinical status:the 17 cases were severe head injury and mild liver injury patients in Ⅰ group.The 18 cases were severe liver injury and mild head injury patients in Ⅱ group. The 11 cases were severe head injury and severe liver injury patients in Ⅲ guoup.The surgical treatment was for performed of severe head injury and severe liver injury.The no-surgical treatment for patients of mild head injury and mild liver.Results Craniotomy of 17 cases and surgical treatment 3 cases of liver injury transformed from no-surgical treatment in Ⅰ group.Case-fatality rate was of 23.5%.Surgical treatment 18 cases of liver injury and craniotomy 4 cases transformed from no-surgical treatment in Ⅱ group.Cases-fatality rate was 33.4%.The whole patients were surgical treatment in Ⅲ group.Case-fatality rate was 72.7%.The death rate of Ⅲ group is significantly higher than Ⅰ group and Ⅱ group.All groups cases-fatality rate was 37.0%.Conclusions It is recommended that early definite diagnose,active to treatment before operation,early craniotomy for reducing the intracranial hypertension and control massive haemorrhage of hepatorrhexis,mastering indication of no-surgical treatment, to attach importance to post operative treatment can reduce the case-fatality rate. [