腹腔镜在外伤性脾破裂保脾治疗中的应用  

Application of Laparoscopic Surgery for Preserving Ruptured Spleen

作　　者：曾志强[1] 裘华德[1] 陶世明[1] 陈务民[1] 吴鹏[1] 高承亚[2] 

机构地区：[1]广东省佛山市中医院普外科,528000 [2]广州市南方医院

出　　处：《岭南急诊医学杂志》2006年第1期21-22,共2页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨腹腔镜下脾破裂止血术治疗外伤性脾破裂的可行性及临床意义。方法:2000年1月～2005年10月,采用腹腔镜脾破裂止血术治疗外伤性脾破裂48例,其中BuntainCT分级Ⅰ型12例,Ⅱ型26例,Ⅲ型10例。其中18例合并其它脏器损伤。结果:44例顺利完成镜下止血手术,手术时间30～150min,平均68.4min。4例因术中出血过多或怀疑合并其它大血管损伤而中转开腹手术。术后出院时间:30例单纯脾破裂6～14d,有合并伤18例12～43d。结论:腹腔镜下脾破裂止血术治疗外伤性脾破裂切实可行,适用于BuntainCT分级I～Ⅲ型脾脏损伤且无严重合并伤的患者。Objective：To explore the feasibility and significance of laparoscopic for preserving ruptured spleen. Methods.We conducted laparoscopic surgery for ruptured spleen in 48 cases of ruptured spleen between January 2000 and October 2005.According to the Buntain classification of CT-graded splenic injury, 12 cases were classified as ＂type Ⅰ ＂,26 cases as ＂type Ⅱ ＂ and 10 cases as ＂type Ⅲ＂. Ruptured spleen was complicated by other organ injuries in 18 cases. Results.The operation was completed successfully in 44 cases, the operation time being 30-150 min （mean, 68.4 min）. A conversion to open surgery was made in 4 cases with massive haemorrhage or was suspected of having injuries of other major vessels. Postoperative time to leaving hospital was 6-14 days in 30 cases of simple ruptured spleen and 12- 43 days in 18 cases of ruptured spleen complicating other injuries. Conclusions：Laparoscopic Surgery for preserving ruptured spleen is feasible for ＂type Ⅰ , Ⅱ or Ⅲ ruptured spleen without severe complicating injuries.

关 键 词：腹腔镜手术 脾脏 损伤 

分 类 号：R657.6[医药卫生—外科学]