Cywes S, Rode H, Millar A J
J Pediatr Surg. 1985 Feb;20(1):14-8. doi: 10.1016/s0022-3468(85)80383-3.
Since 1978, we have treated 19 of 23 (83%) children with blunt liver trauma nonoperatively. Management consisted of observation in an intensive care unit, repeated physical examination, frequent reevaluation of laboratory values, special investigations, and bed rest. The 19 patients all remained stable, required no surgical intervention, and showed resolution of the hepatic injuries with no early or delayed complications. Ultrasonography, although not as reliable a method as computed tomography or liver isotope scans for identification of hepatic trauma at first presentation, provided a very useful method for documenting subsequent progress and eventual healing of the lesions. The presence of an isolated hepatic injury is insufficient indication for surgery. If there is significant extrahepatic injury requiring surgery, or if the patient with hepatic trauma is deteriorating, operative intervention is mandatory.
自1978年以来，我们对23例钝性肝外伤患儿中的19例（83%）进行了非手术治疗。治疗措施包括在重症监护病房观察、反复体格检查、频繁复查实验室值、特殊检查以及卧床休息。这19例患者均保持稳定，无需手术干预，肝脏损伤得以消退，无早期或延迟并发症。超声检查虽然在初次发现肝外伤时不如计算机断层扫描或肝脏同位素扫描那样可靠，但它为记录病变的后续进展和最终愈合提供了一种非常有用的方法。孤立性肝损伤并非手术的充分指征。如果存在需要手术的严重肝外损伤，或者肝外伤患者病情恶化，则必须进行手术干预。
