肝外伤非手术治疗的进展
Evolution of non-operative management of liver trauma.
作者信息
Brooks Adam, Reilly John-Joe, Hope Carla, Navarro Alex, Naess Paal Aksel, Gaarder Christine
机构信息
East Midlands Major Trauma Centre, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Division of Graduate Entry Medicine and Health Sciences, University of Nottingham, Nottingham, Nottinghamshire, UK.
出版信息
Trauma Surg Acute Care Open. 2020 Nov 3;5(1):e000551. doi: 10.1136/tsaco-2020-000551. eCollection 2020.
The management of complex liver injury has changed during the last 30 years. Operative management has evolved into a non-operative management (NOM) approach, with surgery reserved for those who present in extremis or become hemodynamically unstable despite resuscitation. This NOM approach has been associated with improved survival rates in severe liver injury and has been the mainstay of treatment for the last 20 years. Patients that fail NOM and require emergency surgery are associated with increased morbidity and mortality. Better patient selection may have an impact not only on the rate of failure of NOM, but the mortality rate associated with it. The aim of this article is to review the evidence that helped shape the evolution of liver injury management during the last 30 years.
在过去30年中，复杂肝损伤的治疗方式发生了变化。手术治疗已演变为非手术治疗（NOM）方法，手术仅保留给那些病情危急或尽管经过复苏仍出现血流动力学不稳定的患者。这种NOM方法与严重肝损伤患者生存率的提高相关，并且在过去20年中一直是主要的治疗方法。NOM治疗失败且需要急诊手术的患者，其发病率和死亡率会增加。更好的患者选择不仅可能影响NOM的失败率，还可能影响与之相关的死亡率。本文的目的是回顾有助于塑造过去30年肝损伤治疗演变的证据。
Zotero 插件