Department of Surgery, University of Edinburgh, Edinburgh, UK.
HPB (Oxford). 2006;8(1):4-9. doi: 10.1080/13651820500465881.
The liver is the most frequently injured intra-abdominal organ and associated injury to other organs increases the risk of complications and death. This has highlighted the critical need for an accurate classification system as a basis for the clinical decision-making process. Several classification systems have been proposed in an attempt to incorporate the aetiology, anatomy and extent of injury and correlate it with subsequent clinical management and outcome. The widely accepted Organ Injury Scale is based on anatomical criteria that quantify the disruption of the liver parenchyma and defines six groups which may influence management strategies and relate to outcome. The less common pancreatic injury remains a major source of morbidity and mortality due to the likelihood of associated solid or hollow-organ injuries. The implication of a delay in diagnosis and management emphasizes the need for an accurate classification system. The Organ Injury Scale is widely used for pancreas trauma and recognizes the importance of progressive parenchymal injury and in particular ductal injury. Advances in imaging techniques have led to the development of newer radiological classification systems; however, validation of their accuracy remains to be proven. An accurate classification of liver and pancreatic trauma is fundamental for the development of treatment protocols in which clinical decisions are based on the severity of injury.
肝脏是最常受伤的腹腔内器官，其他器官的相关损伤增加了并发症和死亡的风险。这突出表明迫切需要一个准确的分类系统作为临床决策过程的基础。已经提出了几种分类系统，试图将病因、解剖结构和损伤程度纳入其中，并将其与随后的临床管理和结果相关联。广泛接受的器官损伤分级系统基于解剖学标准，这些标准量化了肝实质的破坏，并定义了六个可能影响管理策略并与结果相关的组。不太常见的胰腺损伤仍然是发病率和死亡率的主要原因，因为它可能与实体或中空器官损伤有关。诊断和管理延迟的影响强调了需要一个准确的分类系统。器官损伤分级系统广泛用于胰腺创伤，它认识到进行性实质损伤，特别是导管损伤的重要性。成像技术的进步导致了新的放射学分类系统的发展；然而，其准确性的验证仍有待证明。准确地对肝和胰腺创伤进行分类是制定治疗方案的基础，这些方案的临床决策是基于损伤的严重程度。
