Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2011 Nov;124(22):3757-61.
The aim of this research was to evaluate the feasibility and efficacy of absorbable bandage wrapping in the treatment of cases of severe liver trauma.
Electric firecrackers were detonated in 16 miniature swine to produce a severe blast liver injury. After fluid resuscitation, the animals were randomly divided into two groups (n = 8 each) and were either treated with absorbable bandage wrapping of the injured lobe of liver (Group B) or hepatic lobectomy (Group H). Time to hemostasis, blood loss during the treatment period, and other parameters were compared, including postoperative serum total bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST).
Blood loss during the treatment period was significantly lower in Group B than that in Group H ((81.3 ± 26.0) ml vs. (130.8 ± 29.5) ml, P = 0.0031). Serum AST and ALT were transiently increased post-surgically. These transient increases were significantly higher in Group B. No difference in time to hemostasis was noted ((8.70 ± 2.27) minutes vs. (10.28 ± 1.93) minutes, P = 0.1559) in Groups B and H, respectively. Two pigs were humanely euthanized 28 days post-surgically and the wrapped liver lobes appeared atrophies. Microscopically, there was evidence of emerging and mature fibrous tissue.
Absorbable bandage wrapping is both feasible and effective in the treatment of severe blast liver injury.
本研究旨在评估可吸收绷带包扎治疗严重肝外伤的可行性和疗效。
将电雷管引爆于 16 头小型猪，造成严重爆炸性肝损伤。液体复苏后，动物随机分为两组（n = 8 只/组），分别采用可吸收绷带包扎肝损伤叶（B 组）或肝叶切除术（H 组）治疗。比较两组止血时间、治疗期间出血量等参数，以及术后血清总胆红素（TB）、丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）。
B 组治疗期间出血量明显低于 H 组[（81.3 ± 26.0）ml 比（130.8 ± 29.5）ml，P = 0.0031]。术后血清 AST 和 ALT 一过性升高，B 组升高更明显。两组止血时间无差异[（8.70 ± 2.27）分钟比（10.28 ± 1.93）分钟，P = 0.1559]。术后 28 天，2 头猪被安乐死，包裹的肝叶出现萎缩。镜下可见新生和成熟的纤维组织。
可吸收绷带包扎治疗严重爆炸性肝损伤是可行且有效的。
