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首页> 外文期刊>Acta Chirurgica Latviensis >Start of Polytrauma Management in University Hospital: First Experience with Liver Trauma
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Start of Polytrauma Management in University Hospital: First Experience with Liver Trauma

机译：大学医院开始多创伤治疗：肝创伤的首次体验

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Trauma is a leading cause of death, particularly among young patients. Spleen is the most commonly damaged organ in blunt abdominal trauma and liver injury is the main cause of death.Aim of the study. Review of the literature and recent clinical experience in the management of blunt liver injuries in the Riga East clinical university hospital.Materials and methods. Three-year experience in the management of liver traumatic rupture was retrospectively and prospectively analysed. The study included 64 patients over 15 years of age with blunt hepatic injuries. Exclusion criteria were patients with life-incompatible haemorrhagic shock. The Statistical analysis of the data was performed by median and mean of the Microsoft Excel 2010 and SPSS 22 version.Results. A total of 64 patients were treated in our institution during the period from November 2010 till November 2013. Isolated liver injuries were diagnosed in 49 cases, combined liver and spleen injuries in 15 cases. Most commonly mechanism ofinjury were road traffic accidents, falls and low energy blunt traumas (criminal beaten, sports injuries);19 patients underwent laparotomy for haemostasis while nonoperative management was used in 45 patients. Haemodynamic stability of the patient and CT confirmed liver injury were the main criteria for nonoperative management. One patient died atthe time of laparotomy from injuries not compatible with life – severe head injury with basal skull fracture, aortic arc rupture, flail chest and liver and spleen injury.Conclusions. Conservative management of liver trauma is justified in haemodynamically(HD) stable patients after thorough risk assessment and computed tomography (CT) based injury grading in centres with sufficient expertise and medical resources.
机译：创伤是导致死亡的主要原因，尤其是在年轻患者中。脾脏是腹部钝性损伤中最常见的器官，肝损伤是主要的死亡原因。回顾了里加东临床大学医院治疗钝性肝损伤的文献和最新临床经验。材料和方法。回顾性和前瞻性分析了三年治疗肝外伤性破裂的经验。该研究纳入了64位15岁以上的钝性肝损伤患者。排除标准为生活不相容的出血性休克患者。通过Microsoft Excel 2010和SPSS 22版本的中位数和均值对数据进行统计分析。从2010年11月至2013年11月，本院共收治64例患者。诊断出孤立的肝损伤49例，肝脾合并损伤15例。最常见的伤害机制是道路交通事故，跌倒和低能钝性创伤（犯罪殴打，运动伤害）; 19例因剖腹手术而进行了止血，而45例则采用非手术治疗。患者的血流动力学稳定性和CT证实的肝损伤是非手术治疗的主要标准。一名患者在剖腹手术时因与生命不相容的伤害而死亡-头部严重受伤，基底颅骨骨折，主动脉弧破裂，fl连and以及肝脏和脾脏受伤。在经过充分的风险评估和基于计算机断层扫描（CT）的损伤分级后，在具有足够专业知识和医疗资源的中心，对血流动力学（HD）稳定的患者进行肝外伤的保守治疗是合理的。

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