Drezner A D, Foster J H
Am J Surg. 1975 Apr;129(4):483-9. doi: 10.1016/0002-9610(75)90196-8.
Fifty-one patients with significant recognized hepatic trauma were treated at Hartford Hospital during a four year period ending May 1973. Seventy-five per cent of the injuries were the result of blunt trauma. Many patients had severe associated injuries and three died in the emergency room before operation could be undertaken. Forty-eight patients underwent laparotomy and various types of repair including sixteen resections of significant volumes of nonviable liver. Three patients died in the operating room, but no patient who left the operating room alive after resection diet. Hematologic, pulmonary, renal, and gastrointestinal complications are analyzed in detail. There were no postoperative intrahepatic or subphrenic abscesses in patients undergoing resection and we believe that this is attributable to changes in technic. This review stresses the technical details of the operations as they may relate to the apparent improvement in morbidity and mortality.
在截至1973年5月的四年期间,哈特福德医院共治疗了51例确诊为严重肝外伤的患者。75%的损伤是由钝性创伤所致。许多患者伴有严重的其他损伤,有3例在手术前死于急诊室。48例患者接受了剖腹手术及各种类型的修复手术,其中16例切除了大量无活力的肝脏组织。3例患者死于手术室,但切除术后存活并离开手术室的患者无一例死亡。对血液学、肺部、肾脏和胃肠道并发症进行了详细分析。接受肝脏切除术的患者术后未发生肝内或膈下脓肿,我们认为这归因于技术的改进。本综述着重介绍了手术的技术细节,因为它们可能与发病率和死亡率的明显改善有关。