Department of Pediatric Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan.
Department of Pediatric Surgery, Kurume University School of Medicine Japan, Kurume, Fukuoka, Japan.
Pediatr Int. 2020 Jul;62(7):834-839. doi: 10.1111/ped.14195. Epub 2020 Jul 9.
The aim of this study was to determine the frequency and nature of pediatric blunt chest-abdominal injuries (BCAIs) and to summarize their management, ranging from non-operative management (NOM), with or without angioembolization (AE), to surgical treatment.
This retrospective study included patients admitted to our hospital for BCAIs from January 1996 to December 2017. The age, injury pattern, organs of injury, outcome, and treatment were summarized.
One hundred and thirty-two patients (98 males, 34 females, mean age 7.68 years ± 3.58, range 1-15 years) were included in the study. Their injuries resulted from motor-vehicle traffic incidents (n = 60), single-bicycle injuries (n = 16), falls (n = 33), sports (n = 10), assault (n = 6), abuse (n = 3), and others (n = 4). There were no injured organs in 31 cases, while there were 130 injured organs in 101 cases, including the liver (n = 42), spleen (n = 35), lung (n = 23), kidney (n = 13), intestine (n = 10), pancreas (n = 5), and adrenal gland (n = 2). Angiography (AG) was performed in 20 cases, and NOM with AE was performed in 16 cases, including 17 organs (liver injury [n = 9], splenic injury [n = 5], and kidney injury [n = 4]). Surgical treatment was performed in eight cases (splenic injury in one, pancreas injury in one, and intestinal injury in six). NOM without AE was performed in the other cases.
The management of organ injury must take into consideration the management of integrated bleeding. It is recommended that children with severe organ injury are treated in dedicated trauma centers in which AE is available.
本研究旨在确定小儿钝性胸腹部损伤（BCAI）的频率和性质，并总结其治疗方法，包括非手术治疗（NOM），伴或不伴血管造影栓塞术（AE），以及手术治疗。
本回顾性研究纳入了 1996 年 1 月至 2017 年 12 月期间因 BCAI 收治于我院的患者。总结了患者的年龄、损伤模式、损伤器官、结局和治疗方法。
本研究共纳入 132 例患者（98 例男性，34 例女性，平均年龄 7.68±3.58 岁，1-15 岁）。致伤原因包括机动车交通事故（n=60）、单自行车损伤（n=16）、坠落伤（n=33）、运动伤（n=10）、锐器伤（n=6）、虐待伤（n=3）和其他原因（n=4）。31 例患者无损伤器官，101 例患者有 130 个器官损伤，包括肝脏（n=42）、脾脏（n=35）、肺（n=23）、肾脏（n=13）、肠（n=10）、胰腺（n=5）和肾上腺（n=2）。20 例行血管造影（AG）检查，16 例行 NOM 伴 AE，治疗 17 个器官（肝损伤 9 例，脾损伤 5 例，肾损伤 4 例）。8 例行手术治疗（脾损伤 1 例，胰腺损伤 1 例，肠损伤 6 例）。其余患者行 NOM 未行 AE。
对器官损伤的处理必须考虑综合出血的处理。建议在有 AE 可用的专门创伤中心治疗严重器官损伤的患儿。
