Shah P A, Kulkarni S S, Joshi N, Lakshmy M V, Dewoolkar V V
Department of Surgery, L.T.M. General Hospital, Sion, Bombay, India.
Injury. 1993 May;24(5):303-5. doi: 10.1016/0020-1383(93)90050-g.
A total of 110 patients with hepatic injuries was treated at a major urban trauma centre between June 1988 and December 1991. The mechanism of injury was blunt trauma in 86 patients (78 per cent). Non-operative treatment was given in six patients (5 per cent). Simple hepatorrhaphy, use of topical haemostatic agents or peritoneal drainage alone were performed in 79 (72 per cent) cases. Extensive hepatorrhaphy, hepatotomy with selective vascular ligation, resection and débridement or resection, perihepatic packing and major vascular ligation were undertaken, often in combination, in 25 (23 per cent) cases. Percutaneous arterial embolization was carried out in one case. The mortality rate was 18 per cent. The most frequent postoperative complications related to hepatic injury were intra-abdominal abscess (7 per cent) and coagulopathy (5 per cent); prolonged biliary leak (3 per cent), late haemorrhage (2 per cent) and hepatic necrosis (1 per cent) were also observed.
1988年6月至1991年12月期间，一家大型城市创伤中心共收治了110例肝损伤患者。损伤机制为钝性创伤的有86例（78%）。6例（5%）患者接受了非手术治疗。79例（72%）患者进行了单纯肝缝合、使用局部止血剂或仅行腹腔引流。25例（23%）患者进行了广泛肝缝合、选择性血管结扎的肝切开术、切除与清创或切除术、肝周填塞和主要血管结扎，这些操作常联合进行。1例患者接受了经皮动脉栓塞术。死亡率为18%。与肝损伤相关的最常见术后并发症是腹腔内脓肿（7%）和凝血病（5%）；还观察到持续性胆漏（3%）、迟发性出血（2%）和肝坏死（1%）。
