Yaman Ismail, Nazli Okay, Tugrul Tansug, Isgüder Ali Serdar, Bozdag Ali Dogan, Bölükbasi Hakan
Third Surgical Clinic of Atatürk Training and Research Hospital, Izmir, Turkey.
Hepatogastroenterology. 2007 Jul-Aug;54(77):1507-11.
BACKGROUND/AIMS: We aimed to determine the factors that affect morbidity and mortality in patients that underwent surgery for hepatic injury.
Records of 109 blunt or penetrating hepatic trauma patients that underwent surgery in the Third Surgical Clinic of Izmir Atattürk Training and Research Hospital between 1994 and 2004 were reviewed retrospectively. Evaluated parameters were: age, gender, cause of injury, diagnostic procedures, preoperative blood pressure (BP), hemoglobin (Hb) level, amount of intraabdominal blood, associated injuries, the number of involved hepatic segments and anatomic distribution, severity of injury, abdominal trauma index (ATI), amount of blood transfusions, type of surgery, hospital stay, and rates of morbidity and mortality.
Median age of the patients was 29 years. The injury was penetrating in 53.2% of the patients and blunt in 46.8%. Abdominal blood was 500cc or less in 70 (64.2%) patients. Isolated hepatic injury was encountered in 29 (26.6%) cases. 22.9% of the patients had major injuries. Hemostasis was achieved by electrocautery, sponge-gel, primary suturing, hepatic resection or perihepatic packing. Morbidity and mortality rates were 40.4% and 14.6% respectively.
Age, type of the injury, BP and Hb levels, amount of intraabdominal blood, degree of injury, ATI, and accompanying organ injuries significantly affect morbidity and/or mortality.
背景/目的：我们旨在确定影响肝损伤手术患者发病率和死亡率的因素。
回顾性分析了1994年至2004年间在伊兹密尔阿塔图尔克培训与研究医院第三外科诊所接受手术的109例钝性或穿透性肝外伤患者的记录。评估的参数包括：年龄、性别、损伤原因、诊断方法、术前血压（BP）、血红蛋白（Hb）水平、腹腔内出血量、合并伤、受累肝段数量及解剖分布、损伤严重程度、腹部创伤指数（ATI）、输血量、手术类型、住院时间以及发病率和死亡率。
患者的中位年龄为29岁。53.2%的患者为穿透伤，46.8%为钝性伤。70例（64.2%）患者的腹腔内出血量为500cc或更少。29例（26.6%）病例为单纯肝损伤。22.9%的患者有重伤。通过电灼、海绵凝胶、一期缝合、肝切除或肝周填塞实现止血。发病率和死亡率分别为40.4%和14.6%。
年龄、损伤类型、血压和血红蛋白水平、腹腔内出血量、损伤程度、腹部创伤指数及伴发器官损伤显著影响发病率和/或死亡率。
