복부 둔상 후 간 손상 환자에서 치료방법의 결정요소

• Published in: Daehan oe'sang haghoeji Vol. 13; no. 2; pp. 82 - 89
• Main Authors: 김성환, Seong Whan Kim, 이강현, Kang Hyun Lee, 조준휘, Jun Hwi Cho, 황성오, Sung Oh Hwang, 배금석, Keum Seok Bae, 강성준, Sung Joon Kang, 김선만, Sun Man Kim
• Format: Journal Article
• Language: Korean
• Published: 대한외상학회 01.12.2000
• ISSN: 1738-8767; 2287-1683

Background: After what Dramatic changes have occurred in the management modality for hepatic injury, including the strategy of operative management. However, selection criteria for choosing the treatment modality remain to be determined. The purpose of this study was to determine the factors affecting the decision for the treatment modality of blunt liver injury. Methods: A retrospective review of 46 patients who had blunt hepatic trauma and who were treated at Wonju Christian Hospital from 1997 to 1999 was performed. The patients were divided in two groups (non-operation group vs. operation group) based on the treatment modality. The two groups were compared for injury severity score (ISS), blood pressure, pulse rate, base deficit, liver injury grade, liver enzymes, transfusion amount during initial 12 hours, number of fluid collection sites, age, sex, and mechanism of injury. Results : Although similar in terms of age and sex distribution, as well as the mechanism of injury, the 17 (37%) patients treated operatively had a higher liver-injury grade, higher number of fluid collection sites, a larger initial blood transfusion requirement, and more associated abdominal injuries when compared with the 29 (63%) patients in the non-operative group. There were no differences in initial vital signs and liver enzyme concentration between groups. The transfusion amount during the first 12 hours, the number of fluid collection sites, and the degree of liver injury grade were greater in the operation group than in the non-operation group. Conclusion: The factors affecting the treatment modality of blunt liver injury were the transfusion amount during the first 12 hours, the number of fluid collection sites, and the liver injury grade.