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Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases.巴西乌贝兰迪亚临床医院钝性肝外伤非手术治疗经验:114 例。
Rev Col Bras Cir. 2023 Mar 10;50:e20233424. doi: 10.1590/0100-6991e-20233424-en. eCollection 2023.
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Epidemiological profile of patients undergoing non-operative management of solid organ injury and associated factors with mortality.探讨行非手术治疗的实体脏器损伤患者的流行病学特征及其与病死率相关的因素。
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本文引用的文献

1
Liver trauma: WSES 2020 guidelines.肝脏创伤:WSES 2020 指南。
World J Emerg Surg. 2020 Mar 30;15(1):24. doi: 10.1186/s13017-020-00302-7.
2
Risk factors for mortality in blunt abdominal trauma with surgical approach.采用手术治疗的钝性腹部创伤患者的死亡危险因素。
Rev Col Bras Cir. 2015 Jul-Aug;42(4):259-64. doi: 10.1590/0100-69912015004011.
3
Non-operative management (NOM) of blunt hepatic trauma: 80 cases.钝性肝外伤的非手术治疗(NOM):80例。
Ulus Travma Acil Cerrahi Derg. 2014 Mar;20(2):97-100. doi: 10.5505/tjtes.2014.20737.

巴西乌贝兰迪亚临床医院钝性肝外伤非手术治疗经验:114 例。

Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases.

机构信息

- Hospital das Clínicas da Universidade Federal de Uberlândia, Serviço de Cirurgia Geral - Uberlândia - MG - Brasil.

出版信息

Rev Col Bras Cir. 2023 Mar 10;50:e20233424. doi: 10.1590/0100-6991e-20233424-en. eCollection 2023.

DOI:10.1590/0100-6991e-20233424-en
PMID:36921133
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10519691/
Abstract

INTRODUCTION

trauma is the leading cause of death for the age group from 1 to 49 years in Brazil. Non-Operative Management (NOM) is the gold standard in trauma centers and does not affect mortality in comparison to operative treatment.

METHODS

medical records were reviewed for 114 patients with blunt liver trauma treated at Hospital das Clínicas of the Federal University of Uberlândia (HC-UFU) from November 2015 to November 2020.

RESULTS

the most prevalent gender was masculine (74.5%). The most prevalent age group was 20 to 49 years (65.7%). The majority of admitted patients (60.5%) had an Injury Severity Score (ISS) of more than 15. On hospital admission, 30.7% had HR above 100 bpm and 30.70% had SBP below 100mmHg. NOM was implemented in 77.2% of patients, the failure rate was 11.36% and the specific failure rate, excluding complications of associated injuries that resulted in surgery, was 1.75%. One third of deaths were due to severe traumatic brain injury.

CONCLUSION

the failure rate of NOM in this study is similar to the literature reports for liver trauma. The failure rate, excluding complications of associated injuries, is considered low. The recognition of the epidemiological profile of patients admitted at HC-UFU allows multidisciplinary and integrated care with specialized training, as well as the development of institutional protocols, aiming to reduce morbidity and mortality related to hepatic trauma.

摘要

引言

创伤是巴西 1 至 49 岁年龄段人群的主要死亡原因。非手术治疗(NOM)是创伤中心的金标准,与手术治疗相比,它不会影响死亡率。

方法

对 2015 年 11 月至 2020 年 11 月在联邦大学乌贝兰迪亚临床医院(HC-UFU)接受钝性肝外伤治疗的 114 例患者的病历进行了回顾性分析。

结果

最常见的性别为男性(74.5%)。最常见的年龄组为 20 至 49 岁(65.7%)。大多数入院患者(60.5%)的损伤严重程度评分(ISS)超过 15。入院时,30.7%的患者心率超过 100 次/分,30.70%的患者收缩压低于 100mmHg。77.2%的患者实施了 NOM,失败率为 11.36%,排除与手术相关的损伤并发症导致失败的特定失败率为 1.75%。三分之一的死亡是由于严重创伤性脑损伤。

结论

本研究中 NOM 的失败率与肝外伤的文献报告相似。排除与相关损伤并发症相关的失败率被认为较低。对 HC-UFU 收治患者的流行病学特征的认识,允许多学科和综合护理,具有专门培训,并制定机构方案,旨在降低与肝外伤相关的发病率和死亡率。