Stain S C, Yellin A E, Donovan A J
Department of Surgery, University of Southern California School of Medicine.
Arch Surg. 1988 Oct;123(10):1251-5. doi: 10.1001/archsurg.1988.01400340077013.
Two hundred thirty-three patients were operated on for hepatic trauma during a two-year period. There were 101 patients with stab wounds, 90 with gunshot wounds, and 42 with blunt trauma. There were 56 isolated liver injuries. Three hundred seventy-five associated injuries occurred among the remaining 177 patients. The majority of patients required only drainage. "Liver sutures" were employed in 66 patients. Only 18 patients required débridement, resection, or packing. Twenty-eight patients (12%) died. Perioperatively, 13 patients died of hemorrhage from the hepatic wound and from the associated major vascular injuries that were present in eight of the 13 cases. The remaining deaths were not primarily a consequence of the hepatic wound. Control of hemorrhage remains the dominant consideration in the treatment of major hepatic wounds.
在两年时间里，有233例患者接受了肝外伤手术。其中101例为刺伤，90例为枪伤，42例为钝性创伤。有56例为单纯肝损伤。其余177例患者共发生375处合并伤。大多数患者仅需引流。66例患者采用了“肝缝合术”。仅18例患者需要清创、切除或填塞。28例患者（12%）死亡。围手术期，13例患者死于肝创口出血以及相关的主要血管损伤，这13例中有8例存在此类情况。其余死亡并非主要由肝创口所致。控制出血仍是治疗严重肝创口的主要考虑因素。
