Johnsen Niels V, Betzold Richard D, Guillamondegui Oscar D, Dennis Bradley M, Stassen Nicole A, Bhullar Indermeet, Ibrahim Joseph A
Urological Surgery, Department of Urological Surgery, Vanderbilt University Medical Center, A-1302 Medical Center North, Nashville, TN 37232, USA.
Division of Trauma, Surgical Critical Care, Emergency General Surgery, Department of Surgery, Vanderbilt University Medical Center, 1211 21st Avenue South, 404 Medical Arts Building, Nashville, TN 37212, USA.
Surg Clin North Am. 2017 Oct;97(5):1077-1105. doi: 10.1016/j.suc.2017.06.013.
Surgery used to be the treatment of choice in patients with solid organ injuries. This has changed over the past 2 decades secondary to advances in noninvasive diagnostic techniques, increased availability of less invasive procedures, and a better understanding of the natural history of solid organ injuries. Now, nonoperative management (NOM) has become the initial management strategy used for most solid organ injuries. Even though NOM has become the standard of care in patients with solid organ injuries in most trauma centers, surgeons should not hesitate to operate on a patient to control life-threatening hemorrhage.
手术曾经是实体器官损伤患者的首选治疗方法。在过去20年里，由于无创诊断技术的进步、侵入性较小的手术的可用性增加以及对实体器官损伤自然病程的更好理解，这种情况已经发生了变化。现在，非手术治疗（NOM）已成为大多数实体器官损伤的初始治疗策略。尽管在大多数创伤中心，NOM已成为实体器官损伤患者的标准治疗方法，但外科医生在遇到需要控制危及生命的出血的患者时，应毫不犹豫地进行手术。
