Management of 1000 Consecutive Cases of Hepatic Trauma (1979–1984)
Management of 1000 Consecutive Cases of Hepatic Trauma (1979–1984)
复制标题
连续处理1000例肝外伤（1979-1984）
作者：
D. Feliciano;K. Mattox;G. L. Jordan;J. Burch;C. Bitondo;P. Cruse
1979~1984年，城市创伤中心共收治1000例肝损伤患者。86.4%的患者存在穿透伤。在881名患者中，单纯肝修补、使用局部止血剂或单纯引流是唯一需要的治疗形式，其中65人(7.3%)死亡。119例患者需要广泛的肝修补术或肝切除加选择性血管结扎、清创或切除、选择性肝动脉结扎或肝周填塞，其中40例(33.6%)死亡。存活超过48小时的918例患者中，798例(86.9%)出现了无并发症的恢复。在其余13.1%的患者中，腹内脓肿形成是最常见的晚期并发症(32/918=3.5%)。整个1000名患者的死亡率为10.5%，其中78.1%(82/105)的死亡发生在围手术期，死于休克或输血相关的凝血疾病。
From 1979 to 1984, 1000 patients with hepatic injuries were treated at one urban trauma center. Penetrating wounds were present in 86.4% of patients. Simple hepatorrhaphy, use of topical hemostatic agents, or drainage alone were the only forms of therapy required in 881 patients, and 65 (7.3%) died. Extensive hepatorrhaphy or hepatotomy with selective vascular ligation, resectional debridement or resection, selective hepatic artery ligation, or perihepatic packing were required, often in combination, in 119 patients, and 40 (33.6%) died. Uncomplicated recoveries occurred in 798 of the 918 patients (86.9%) surviving greater than 48 hours. In the remaining 13.1% of patients, intra-abdominal abscess formation was the most common late complication (32/918 = 3.5%). Mortality for the entire series of 1000 patients was 10.5%, with 78.1% (82/105) of all deaths occurring in the perioperative period from shock or transfusion-related coagulopathies.