胃癌术中医源性脾脏损伤切除的临床分析  

Clinical analysis of 11 cases of iatrogenic splenic injury and resection in gastric cancer surgery

作　　者：赵平[1] 唐令超[1] 丁志[1] 周祥[1] 

机构地区：[1]四川省肿瘤医院普外科,成都610041

出　　处：《中国肿瘤临床与康复》2014年第9期1084-1086,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨胃癌手术治疗中医源性脾损伤导致脾脏切除的危险因素和预防处理方法。方法回顾性分析2002年3月至2011年12月间1 241例胃癌切除手术中发生11例医源性脾脏损伤进行脾脏切除患者的临床资料。结果远端胃大部切除、近端胃大部切除和全胃切除术中分别发生医源性脾脏损伤导致脾脏切除2例、5例和4例,其中因为脾脏动脉或者静脉损伤2例,脾脏包膜及实质损伤9例,合并胰尾部切除2例。术后未因为出血再次手术,全组均痊愈出院。结论胃肿瘤手术导致脾损伤的发生与手术方式和术者技术状态相关,通过提前粘连分离和仔细钳夹结扎,这种损伤可以预防或降到最低限度的。一般脾脏损伤可以通过常规方法安全止血,必要时再采用脾脏切除术。Objective To probe the methods in prevention and treatment of splenic injury in the surgical procedure of gastric carcinoma. Methods A retrospective clinical data analysis of 11 full-splenec- tomy of splenic injury patients from 1 241 patients with gastric carcinoma under gone surgery in the past 9 years in our professional team. Results There were 2,5 , 4 full-splenectomy cases in the surgical proce- dure of gastric carcinoma respectively. All of the 11 cases were discharged from hospital with fully recovery without re - operation for postoperative bleeding. Conclusion Splenic injury occured in the surgical proce- dure of gastric carcinoma related to the types of operation and skills training of surgeon, and it can be pre- vented or reduced by raising our awareness and improving the operation. Splenic injury could be stopped hemorrhage safely by usual treatments, full-splenectomy if necessary o

关 键 词：胃肿瘤 手术治疗 脾损伤 脾脏切除 

分 类 号：R735.2[医药卫生—肿瘤]