Gackowski W, Najnigier B, Otto W, Paczkowski P M, Krawczyk M, Karwowski A
Katedry i Kliniki Chirurgii Ogólnej i Chorób Watroby Akademii Medycznej w Warszawie.
Wiad Lek. 1997;50 Suppl 1 Pt 2:223-7.
From 1990 to 1996 two hundred and sixteen patients with abdominal trauma were treated in our Department. In 170 cases there were blunt, and in 46-penetrating injuries (stab and gunshot wounds). Injuries of the other regions of the body coexisted in 117 patients (multiple trauma). In 42 cases (19.4%) abdominal trauma caused injury to the liver. In this group blunt mechanism of trauma also dominated (71%). The victims were usually young men (90% of the group, mean age - 35.3 years). The most common cause of injury were traffic accidents (47.6%), penetrating injury being the second commonest cause (12 patients i.e. 29%). Four patients were treated conservatively, the remaining 38 required surgical intervention. Most frequently liver suture and peritoneal drainage were performed (20), followed by liver tissue resections (16) and liver packing (12). Other surgical procedures to treat coexisting injuries were performed in 24 patients. In 22 patients postoperative complications occurred: liver abscess in 6 cases, hemorrhage in 4, wound infection in 4, biliary fistula in 2, intrahepatic aneurysm in 2 and other complications in 8 patients. The mean time of hospitalisation were of 20 days (range: 0-64 days). Mean volume of blood transfused equaled 6.9 U. There were 16 deaths (38%), in all cases in multiple trauma victims. All patients with penetrating liver trauma survived.
1990年至1996年,我科共收治216例腹部创伤患者。其中170例为钝性伤,46例为穿透伤(刺伤和枪伤)。117例患者合并身体其他部位损伤(多发伤)。42例(19.4%)腹部创伤导致肝脏损伤。该组中钝性创伤机制也占主导(71%)。受害者通常为青年男性(占该组的90%,平均年龄35.3岁)。最常见的受伤原因是交通事故(47.6%),穿透伤是第二常见原因(12例,即29%)。4例患者接受保守治疗,其余38例需要手术干预。最常进行的是肝脏缝合和腹腔引流(20例),其次是肝组织切除(16例)和肝脏填塞(12例)。24例患者还进行了治疗合并伤的其他手术。22例患者出现术后并发症:肝脓肿6例,出血4例,伤口感染4例,胆瘘2例,肝内动脉瘤2例,8例患者出现其他并发症。平均住院时间为20天(范围:0 - 64天)。平均输血量为6.9单位。16例死亡(38%),均为多发伤受害者。所有穿透性肝创伤患者均存活。