Amroch D, Schiavon G, Carmignola G, Zoppellaro F, Marzaro M, Berton F, Perrino G
Department of Pediatric Surgery, Regional Hospital of Treviso, Padova, Italy.
J Pediatr Surg. 1992 Apr;27(4):466-8. doi: 10.1016/0022-3468(92)90338-8.
During the past 8 years 13 children with isolated blunt liver trauma were managed nonoperatively. All patients selected for this management were hemodynamically stable after initial resuscitation and were without signs of other associated intraabdominal injuries on ultrasonogram and/or computed tomography. Patients were observed in an intensive care unit for at least 48 hours with repeated clinical assessments, laboratory studies, and bed rest. One patient with type 3 injury was operated on 8 days after injury because of sudden intraperitoneal bleeding on ambulation. Five patients required blood transfusions of not more than 300 mL per patient. Laboratory values returned to normal from 7 to 21 days after injury. Resolution of hepatic injury on ultrasonogram took from 1 to 3 months. Complete bed rest was prescribed for at least 10 days depending on the type of injury, with restricted activities up to 3 months postinjury. No complications were seen in this series.
在过去8年中，对13例单纯性钝性肝外伤患儿进行了非手术治疗。所有选择这种治疗方法的患者在初始复苏后血流动力学稳定，超声检查和/或计算机断层扫描未显示其他相关腹腔内损伤的迹象。患者在重症监护病房观察至少48小时，期间进行反复的临床评估、实验室检查并卧床休息。1例3型损伤患者在伤后8天因行走时突然腹腔内出血而接受手术。5例患者每人所需输血量不超过300 mL。伤后7至21天实验室值恢复正常。超声检查显示肝损伤的愈合需要1至3个月。根据损伤类型，规定至少完全卧床休息10天，伤后3个月内限制活动。该系列中未出现并发症。
