Jin Wangxun, Deng Liming, Lv Heping, Zhang Qiyu, Zhu Jinying
Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000; ; Department of Abdominal Tumor Surgery, Zhejiang Provincial Cancer Hospital, Hangzhou 310000;
Exp Ther Med. 2013 Feb;5(2):395-398. doi: 10.3892/etm.2012.837. Epub 2012 Nov 27.
Blunt liver trauma is the most dangerous and the second most frequent solid organ trauma that occurs in the abdominal cavity. Management of this life-threatening situation remains a significant challenge. The present study identified that the patterns of blunt liver trauma were closely correlated with the characteristics of the blunt force. Illustrations of findings from this study have been included in the hope that they may aid surgeons in improving the management of this emergency. In total, 53 cases of blunt liver trauma that underwent laparotomy in the First Affiliated Hospital of Wenzhou Medical College between 1999 and 2009 were retrospectively studied. The cause of the injury, the direction and site of the blunt force, surgical records and CT films were carefully studied to obtain information on the patterns and severity of the liver injury and the correlation with blunt forces. Trauma in the right lobe of the liver was mainly caused by acceleration, deceleration and compression of the liver, while in the left lobe of the liver, acceleration was the main cause of the trauma. Liver lacerations were always located close to the attachment sites of the ligaments which bore the majority of the shearing stress. The characteristics of the blunt force play a key role in the different patterns of blunt liver trauma. A thorough understanding of the mechanisms of blunt liver trauma may aid doctors in the management of patients with this condition.
钝性肝损伤是腹腔内最危险且第二常见的实质性器官损伤。处理这种危及生命的情况仍然是一项重大挑战。本研究发现钝性肝损伤的类型与钝性外力的特征密切相关。本研究结果的图示已被纳入，希望它们能帮助外科医生改善对这种急症的处理。总共对1999年至2009年间在温州医学院附属第一医院接受剖腹手术的53例钝性肝损伤病例进行了回顾性研究。仔细研究损伤原因、钝性外力的方向和部位、手术记录及CT片，以获取肝损伤的类型和严重程度以及与钝性外力相关性的信息。肝右叶损伤主要由肝脏的加速、减速和挤压引起，而肝左叶损伤，加速是主要原因。肝裂伤总是位于承受大部分剪切力的韧带附着部位附近。钝性外力的特征在钝性肝损伤的不同类型中起关键作用。深入了解钝性肝损伤的机制可能有助于医生处理患有这种病症的患者。
