외상성 간손상 환자의 치료 방법에 따른 예후 인자
Treatment and Prognostic Factors for Traumatic Liver Injury
배정민, 김낙희, 이현규, 전규하, 전봉춘, 배종대, 정호근, 정기훈, 정병욱, 배성한,
소속 상세정보
배정민 ( Bae Jung-Min )
동국대학교 의과대학 외과학교실
김낙희 ( Kim Nak-Hee )
동국대학교 의과대학 외과학교실
이현규 ( Lee Hyun-Kyu )
동국대학교 의과대학 외과학교실
전규하 ( Jun Kyu-Ha )
동국대학교 의과대학 외과학교실
전봉춘 ( Jun Bong-Chun )
동국대학교 의과대학 외과학교실
배종대 ( Bae Jong-Dae )
동국대학교 의과대학 외과학교실
정호근 ( Jung Ho-Keun )
동국대학교 의과대학 외과학교실
정기훈 ( Jung Ki-Hoon )
동국대학교 의과대학 외과학교실
정병욱 ( Jung Byeong-Wuk )
동국대학교 의과대학 외과학교실
배성한 ( Bae Sung-Han )
동국대학교 의과대학 외과학교실
KMID : 0371320040660060490
Abstract
Purpose: Due to its size and locatin, the liver is frequently injured in abdominal trauma. Recently, nonoperative management for liver injuries has been extended due to the development CT imaging, intensive care units, and their equipment and techniques. Herein, patients with traumatic liver injury were analyzed to evaluate its treatment and prognostic factors.
Methods: From 2001, January to 2003, ,July, 65 patients at our facility were confirmed to have traumatic liver injury. The operative or nonoperative managements were decided on the basis of the systolic blood pressure if no peritoneal irritation sign was noted. If the systolic blood pressure was stable, or recovered to within the normal range following hydration and transfusion at the emergency room, patients were managed nonoperatively. Hemodynamically unstable patients were managed operatively. The data were analysed using the SPSS program (Chi-squared tests and logistic regression analyses).
Results: 48 patients were treated nonoperatively, with 3 mortalities. The overall mortality rate was 15.8%, but only 6.4% in the nonoperative management group, compared to 67% in operative management group. In a Multivariate analysis the systolic blood pressure was found to be a reliable factor in traumatic liver injury and the mentality and ISS (injury severity score) reliable in finding complications in the nonoperative management group. The mentality was found statistically reliable for determining mortality in the operative management group, with the exception for the systolic blood pressure.
Conclusion: The systolic blood pressure was an important indicator when considering the treatment plan in traumatic liver injury. An extensive study will be required that incorporates both nonoperative and operative management groups.
키워드
외상성 간손상;수축기 혈압;비 수술적 치료;Traumatic liver injury;Systolic blood pressure;Nonoperative management
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