保脾手术治疗外伤性脾破裂36例  

Spleen-preserving operation for the treatment of traumatic splenic rupture:An analysis of 36 cases

作　　者：詹慧春 徐早华 曾卫华 丁华民 傅华群[2] 

机构地区：[1]乐安县第二人民医院,江西省乐安县344301 [2]南昌大学第二附属医院肝胆外科,江西省南昌市330006

出　　处：《世界华人消化杂志》2012年第34期3394-3396,共3页World Chinese Journal of Digestology

摘　　要：目的:总结外伤性脾破裂进行保脾手术治疗的临床经验.方法:收集我院2003-01/2012-06收治的外伤性脾破裂患者85例,回顾性分析其中36例行保脾手术治疗患者的临床资料.结果:12例患者先经热敷压迫,再用生物胶涂在损伤组织表面,后用大网膜片覆盖;19例患者行脾下部不规则切除,再行修补;5例患者行大部分脾切除后保留有边缘血供的残留脾.全部患者获得治愈,住院平均时间为22.6d±19.0d,发生并发症8例,经对症处理后均痊愈出院.随访效果均较为满意.结论:外伤性脾破裂治疗原则:(1)抢救生命第一,保留脾脏第二;(2)儿童优先选择脾保留手术,且首选非手术治疗;(3)根据脾脏损伤程度、类型选择最佳术式,实施个体化治疗,可取得满意疗效.AIM： To discuss our experience in managing traumatic splenic rupture by spleen-preserving operation. METHODS： Eighty-five cases of splenic trau- matic rupture were selected, and 36 of them were retrospectively analyzed. RESULTS： Twelve patients was treated by hot compress, application of biological glue to injury tissue surface, and coverage using the greater omentum flap. Nineteen patients were treated by irregular splenectomy and splenic wound re- pair. Five patients underwent subtotal splenec- tomy. Complications occurred in 8 patients and were cured after proper treatments. The median length of hospital stay was 22.6 d ±19.0 d. All patients were satisfactory for the treatment.CONCLUSION： For patients with traumatic splenic rupture, saving life is more important than preserving the spleen. For children patients, spleen-preserving operation is preferred. An ap- propriate treatment should be selected based on the patient＇s condition.

关 键 词：保脾 外伤性脾破裂 脾切除 

分 类 号：R657.6[医药卫生—外科学]