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孤立性肝外伤:非急诊肝脏手术中心的临床视角

Isolated liver trauma: A clinical perspective in a non-emergency center for liver surgery.

作者信息

Andrei Stefan, Isac Sebastian, Carstea Maricica, Martac Cristina, Mihalcea Lucian, Buzatu Cristina, Ionescu Dorin, Georgescu Dragos Eugen, Droc Gabriela

机构信息

Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania.

Department of Anesthesiology and Intensive Care, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

出版信息

Exp Ther Med. 2022 Jan;23(1):39. doi: 10.3892/etm.2021.10961. Epub 2021 Nov 11.

Abstract

The management of liver trauma is, currently, still heterogeneous ranging from conservative to major invasive liver resections. When appropriate, these cases should be referred to a regional care center. The objective of this study was to analyze the expertise of a non-emergency center for liver surgery from Romania after initial stabilization in county hospitals. This study is a monocentric, retrospective, observational study, including 12 patients with hepatic trauma after a car accident, admitted between 2015 and 2019. We analyzed various clinical and biochemical data as independent variables, and the main outcome was considered the intensive care unit (ICU) length of stay. Our results revealed that intubation status at admission, norepinephrine infusion during surgery, hyperfibrinogenemia and duration of mechanical ventilation in patients with isolated liver trauma were correlated with prolonged ICU length of stay. Further prospective, more comprehensive studies are needed in order to evaluate the exact prognostic factors in terms of short- and long-term mortality.

摘要

目前,肝外伤的治疗方式仍然多种多样,从保守治疗到大型侵入性肝切除术都有。在适当的时候,这些病例应转诊至区域护理中心。本研究的目的是分析罗马尼亚一家非急诊中心在县医院进行初步稳定治疗后进行肝脏手术的专业水平。本研究是一项单中心、回顾性、观察性研究,纳入了2015年至2019年间收治的12例车祸后肝外伤患者。我们将各种临床和生化数据作为自变量进行分析,主要结局指标为重症监护病房(ICU)住院时间。我们的结果显示,单纯肝外伤患者入院时的插管状态、手术期间去甲肾上腺素输注、高纤维蛋白原血症以及机械通气时间与ICU住院时间延长相关。为了评估短期和长期死亡率方面的确切预后因素,还需要进一步进行前瞻性、更全面的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09a1/8613533/1a11deadb725/etm-23-01-10961-g00.jpg

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