Stylianos S
Division of Pediatric Surgery, Columbia University College of Physicians & Surgeons, New York, NY, USA.
Semin Pediatr Surg. 1995 May;4(2):116-9.
The treatment of children who have major abdominal injuries has changed significantly during the past 2 decades. Surgical restraint has been the theme, and increased awareness of anatomic patterns and physiological responses has prompted successful nonoperative care of many solid organ injuries in children. The contributions of interventional radiologists and endoscopists in the treatment of injured children continue to increase. Injuries to the biliary tree and pancreatic ductal system are now treated with a multidisciplinary approach combining percutaneous, open, and endoscopic procedures. Trauma surgeons unfamiliar with a nonoperative approach often raise questions about the benefits of such treatment. Their concerns include the potential for increased transfusion requirements, increased length of hospital stay, and missed associated injuries; some even question the involvement of pediatric surgeons in nonoperative treatment protocols. The experience that has settled most such controversies is reviewed in this article.
在过去20年中，患有严重腹部损伤儿童的治疗方法发生了显著变化。手术节制一直是主题，对解剖模式和生理反应认识的提高促使对许多儿童实体器官损伤成功进行非手术治疗。介入放射科医生和内镜医生在受伤儿童治疗中的贡献不断增加。现在，采用经皮、开放和内镜手术相结合的多学科方法治疗胆道树和胰管系统损伤。不熟悉非手术方法的创伤外科医生常常对这种治疗的益处提出疑问。他们担心的问题包括输血需求增加、住院时间延长以及漏诊相关损伤；有些人甚至质疑小儿外科医生参与非手术治疗方案。本文回顾了已解决大多数此类争议的经验。
