MANAGEMENT OF THE SEVERITY OF TYPE III BLUNT LIVER INJURY
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概要
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In 1996, we established guidelines for the management of liver injury, consisting of transcatheter arterial embolization (TAE), conservative management (CM), or operative management (OM) on the basis of blood pressure, presence of response to fluid therapy, and findings of computed tomography (CT) etc. We have applied these guidelines to type III blunt liver injury (the subject of this study) as well. In this study we retrospectively examined whether these guidelines were suitable together with consideration of whether it was necessary to add two more criteria, injury severity score (ISS) and revised trauma score (RTS), both of which are quantitative indices of the severity of injury. In this study we examined 25 cases that were classified into the above three groups. Eighteen cases (72%) were classified into the non-operative management groups, and all the patients in these groups were safely and effectively treated without changing the initial therapeutic strategy. Systolic blood pressure, ISS, and RTS in the OM group were significantly different from those in the other two groups. In the OM group, blood loss was greater because of the higher severity of multiple injuries, thus leading to hypotension with altered consciousness level and respiratory rate. These findings not only indicate that systolic blood pressure can substitute ISS or RTS, but also verify the usefulness of the current guidelines, suggesting that non-operative management is possibly indicated even in type III blunt liver injury.
- 日本臨床外科学会の論文
日本臨床外科学会 | 論文
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