Gaspar Bogdan, Negoi Ionut, Paun Sorin, Hostiuc Sorin, Ganescu Roxana, Beuran Mircea
Department of General Surgery, Emergency Hospital of Bucharest, Romania.
National Institute of Legal Medicine, Bucharest, Romania.
Maedica (Bucur). 2014 Jun;9(2):168-72.
Nowadays we are facing a steep increase in non-operative management throughout the injured body areas, with a continuous increase in the injuries' grade.
To evaluate the safety and applicability of non-operative management in major trauma patients.
Prospective observational study, in a level I trauma center, during 30 months.
major trauma patients with abdominal visceral lesions.
There were 207 major trauma patients whose average age was 35.8 ± 17.2 years, male being 69.6%. The most severe abdominal injuries were in the spleen (32.9%), the liver (19.2%) and the small bowel (11.6%). For the spleen lesions, the non-operative management was successful in 57.9% cases , with a failure rate of 11.6%. Non operative management was successful in 50% of liver injuries, its rate of success being independent of the hepatic injury grade.
Selective non operative management of abdominal visceral injuries is safe and effective in major trauma patients. Nevertheless, we should stress that this type of protocol should be applied only by highly trained surgeons, able to early convert this management to difficult surgical strategies.
如今，我们在整个受伤身体部位面临着非手术治疗的急剧增加，且损伤程度持续上升。
评估非手术治疗在严重创伤患者中的安全性和适用性。
在一级创伤中心进行为期30个月的前瞻性观察研究。
患有腹部内脏损伤的严重创伤患者。
共有207例严重创伤患者，平均年龄为35.8±17.2岁，男性占69.6%。最严重的腹部损伤发生在脾脏（32.9%）、肝脏（19.2%）和小肠（11.6%）。对于脾脏损伤，非手术治疗成功率为57.9%，失败率为11.6%。非手术治疗在50%的肝脏损伤中成功，其成功率与肝损伤程度无关。
对严重创伤患者进行腹部内脏损伤的选择性非手术治疗是安全有效的。然而，我们应强调，这种治疗方案仅应由训练有素的外科医生应用，他们能够在早期将这种治疗转换为困难的手术策略。
