腹部实体器官钝伤的保守治疗经验

Parilal Barman, Nilutpal Bhattacharjee, Prasenjit Baruah
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摘要

肝脏、脾脏和肾脏等腹部实体器官是人体最重要的器官之一。肝脏是人体第二大器官,约占成人体重的 2%。脾脏是淋巴系统中最大的器官。两个肾脏共占人体总重量的 0.4%。它们发挥着许多重要功能,包括排泄和解毒、凝血、免疫功能、吸收和储存必需的矿物质以及储存和过滤血液。肝脏、脾脏和肾脏的损伤是钝性创伤中最常见的实体器官损伤之一。预期的处理方案包括在急诊室进行初步诊断和抢救(包括胸部和骨盆 X 光检查以及床旁超声波检查),然后进行横断面成像(根据需要使用 CT 和造影剂增强多相方案进行基于方案的创伤成像)。在进行初步复苏的同时,应监测生命体征,最好在重症监护室或重症监护病房进行观察,直到完成明确的成像和报告,并制定治疗计划。应根据患者的年龄、是否合并其他疾病以及生理状态的变化来制定治疗方案。所有年龄段的患者,无论损伤程度如何,如果没有其他需要干预的腹部损伤,只要血流动力学状态稳定,都应首选非手术治疗:腹部、实体、肝脏、脾脏、肾脏、损伤、非手术治疗
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experience of Conservative Management of Abdominal Solid Organ Blunt Trauma
Abdominal solid organs like liver, spleen and kidneys are one of the most vital organs of the human body. Liver is the second largest organ of human body with about 2 percent of body weight in adults. The spleen is the largest organ of the lymphatic system. Both the kidneys together represent 0.4 percent of the total body weight. They perform many of the vital functions involving excretion and detoxification, coagulation, immune function, absorption and storage of essential minerals and storage and filtration of blood. Injury to the liver, spleen and kidneys are one of the most common solid organ injuries in blunt trauma. The expected line of management includes initial diagnostics and resuscitation in the emergency room (including chest and pelvic X-ray, and bedside ultrasonography) followed by cross-sectional imaging (protocol-based trauma imaging with CT and contrast-enhanced multiphase protocols according to need). Initial resuscitation should be done in parallel with monitoring of vital signs with observation preferably in an ICU or high-dependency ward until definitive imaging and reporting has been completed and a management is planned. Treatment should be planned as per age, presence of co-morbidities, and changes in physiological status of the patient. Non-operative management should be preferred in patients of all ages irrespective of the grade of injury and in the absence of other abdominal injuries requiring interventions provided that the haemodynamic status is stable. Key words: Abdominal, solid, liver, spleen, kidney, injury, non-operative
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