Feliciano D V, Mattox K L, Jordan G L, Burch J M, Bitondo C G, Cruse P A
Ann Surg. 1986 Oct;204(4):438-45. doi: 10.1097/00000658-198610000-00012.
From 1979 to 1984, 1000 patients with hepatic injuries were treated at one urban trauma center. Penetrating wounds were present in 86.4% of patients. Simple hepatorrhaphy, use of topical hemostatic agents, or drainage alone were the only forms of therapy required in 881 patients, and 65 (7.3%) died. Extensive hepatorrhaphy or hepatotomy with selective vascular ligation, resectional debridement or resection, selective hepatic artery ligation, or perihepatic packing were required, often in combination, in 119 patients, and 40 (33.6%) died. Uncomplicated recoveries occurred in 798 of the 918 patients (86.9%) surviving greater than 48 hours. In the remaining 13.1% of patients, intra-abdominal abscess formation was the most common late complication (32/918 = 3.5%). Mortality for the entire series of 1000 patients was 10.5%, with 78.1% (82/105) of all deaths occurring in the perioperative period from shock or transfusion-related coagulopathies.
1979年至1984年期间，一家城市创伤中心收治了1000例肝损伤患者。86.4%的患者存在穿透性伤口。881例患者仅需单纯肝缝合术、使用局部止血剂或单纯引流等治疗方式，其中65例（7.3%）死亡。119例患者需要进行广泛肝缝合术或肝切开术并选择性血管结扎、切除清创或切除术、选择性肝动脉结扎或肝周填塞，这些治疗方式常联合使用，其中40例（33.6%）死亡。在918例存活超过48小时的患者中，798例（86.9%）康复顺利。在其余13.1%的患者中，腹腔内脓肿形成是最常见的晚期并发症（32/918 = 3.5%）。1000例患者的总死亡率为10.5%，所有死亡病例中有78.1%（82/105）发生在围手术期，死因是休克或输血相关凝血病。
