Künt Travmaya Bağlı Karaciğer Yaralanmalarında Prognozu Etkileyen Faktörler

Abstract

Bu çalışmada, 1982-1990 arasında, Akdeniz Üniversitesi Tıp Fakül- tesi Genel Cerrahi Anabilim Dalı'nda, tedavi edilen 41 künt karaciğer iravması vakası prospektif olarak değerlendirilmiştir, Vaka'lardan 10'u izole (% 24.4), 31'i ise (% 75.6) multitravmalıdır. Serideki ortalama mortalite © 34.'dir. Mortalitede etken olan en önemli faktörler, şok (% 42.9) ve serebral nedenlerdir (%4 35.7). İzole karaciğer yaralanmalarında ölüm görülmezken, multitravmalı has- talarda bu oran “%45.2'dir. Dördüncü ve beşinci derece lezyonlarda mortalite oranı %50 ve %75 olarak saptanmıştır. İlk üç derecedeki mortalite multitravmaya ve bune bağlı olarak (55 puanının yüksekliğine bağlıdır. Müracaatta, ağır hipotansiyon-şok tablosunda gelen hastaların prognozu, oldukça kötüdür. Bunda, yandaş organ lezyonlarının, hipovolemi-hipoksi ilişkisiyle serebral hasar etkileşiminin, rolü büyüktür.

Keywords

• Künt Karaciğer Travması.
• karaciğer
• hipotansiyon-şok tablosun

Factors İnHuancing ihe Outcome in Blunt Hepaliz Trauma

Abstract

A prospective analysis of 41 bluni hepalic trauma Cases between 1982-1990 in Akdeniz Üniversity department of surgery is presented. Particular attention has been focused to determine the prognostic, factors influencing the outcome, Ten patients had isolated hepatic lesions (% 24.4) compared with other 3i (% 75.6) with multiple trauma. The overall mortality rate ot the series i5 % 34.1. Shock on admission and brain detoriation, accounting for “% 42.9 and % 35.7 of deaths respectively, are the firsi two important factors affecting the outcome, There were no deaiths among isolated hepatic injury patients, but % 45.2 mortality was recorded in multiple trauma cases. Mortality was “% 50 and % 75 respectively in IV. and V. degree hepatic lesions, whereas mortaliiy was due to multiple trauma and high 155 scores in the first three degries of hepatic lesions. It is conecluded that, severe hypotension at the time of presentation, indicetes a poor prognosis. Multiple trauma and severe hypovolemic low flow shock, when associated with contussive brain injuries, increases the risk for mortality.

Keywords

• Blunt hepatic trauma
• liver
• hypotension-shock picture

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