食管癌术中医源性脾损伤的预防及临床对策(附21例报告)  

Prevention and clinical management of iatrogenic splenic injury in esophageal cancer operation:report of 21 cases

作　　者：戚维波[1] 胡奕[1] 王明堂[1] 张雁飞[1] 

机构地区：[1]浙江省嘉兴市第一医院心胸外科,嘉兴314000

出　　处：《临床医学》2007年第3期18-19,共2页Clinical Medicine

摘　　要：目的探讨食管癌手术中脾脏损伤的预防措施及发生后的临床对策。方法总结分析一组共492例食管癌根治术中发生脾脏损伤共21例患者的临床资料。结果21例患者中Ⅰ度损伤12例,Ⅱ度损伤7例,Ⅲ度损伤2例;行各种方式的脾脏修补术17例,无法保留脾脏行脾切除者4例;术后发生脾窝感染1例,血小板增高给予抗凝治疗1例;所有患者无术后腹腔出血,均痊愈出院。结论食管癌手术中需防止脾脏的损伤,一旦发生需采取合理的措施防止损伤扩大,尽量避免脾脏切除,以利于术后恢复。Objective To study prevention and clinical management of iatrogenic splenic injury in esophageal cancer operation. Methods The data of 21 patients with iatrogenic splenic injury among 492 patients receiving resection of esophageal cancer were analysed. Results Of all the patients, class Ⅰ injury was 12, class Ⅱ injury was 7, class Ⅲ injury was 2 cases. The operation procedures for 17 cases were simple repair of spleen, and for 4 cases were splenectomy. Subphrenic abscess occured in one patient and thrombocythemia occurred in another patient. All the patients were cured. Conclusion Iatrogenic splenic injury should be avoided in esophageal cancer operation. Once the injury occurred, the right management can avoid massive hemmorrhage and splenectomy.

关 键 词：食管癌 脾损伤 脾切除 

分 类 号：R735.2[医药卫生—肿瘤]