间歇性脾动脉阻断在医源性脾损伤中的应用  

Application of intermittent splenic artery occlusion in iatrogenic splenic injury

作　　者：李志超 朱孝成 李超 时林森 王辉 孟松 姚立彬 

机构地区：[1]徐州医科大学研究生院普外科,徐州221004 [2]徐州医科大学附属医院胃肠外科

出　　处：《腹部外科》2016年第6期442-444,共3页Journal of Abdominal Surgery

摘　　要：目的总结间歇性脾动脉阻断联合明胶海绵压迫在医源性脾损伤保脾手术中的应用。方法回顾分析2013年1月至2015年12月徐州医学院附属医院收治的胃癌手术操作相关的Ⅰ、Ⅱ级脾损伤病例共18例，所有病例均采用间歇性脾动脉阻断联合明胶海绵压迫创面止血，脾动脉阻断时间首次为15min，如仍有出血，再依次继续阻断10min、5min，然后解除阻断及压迫观察止血效果。结果14例经阻断后压迫15min成功止血，4例经阻断压迫25min成功止血。术后均无再次出血、腹腔脓肿、脾脏坏死等并发症，术后3周内血小板计数均〈500×10^9／L。结论对于Ⅰ级、Ⅱ级医源性脾损伤间歇性脾动脉阻断联合明胶海绵压迫止血安全有效。Objective To summarize the application of intermittent splenic artery occlusion combined with gelatin sponge oppression in spleen-preserving surgery of iatrogenic splenic injury. Methods A retrospective analysis was performed on the total of 18 cases of splenic injury with grade Ⅰ or Ⅱ related to gastric surgical procedures from Jan. 2013 to Dec. 2015 in the Department of Gastrointestinal Surgery in the Hospital Affiliated to Xuzhou Medical University. All patients were treated with intermittent splenic artery occlusion combined with gelatin sponge oppression of the wound to stop bleeding. The first time of splenic artery occlusion was 15 min, and continuous blocking was done for 10 min and 5 rain if still bleeding. Hemostatic effect after removing blocking and oppression was observed. Results Fourteen cases had got successfully hemostasis after 15 rain splenic artery occlusion and wound oppression, and the bleeding stopped in another 4 cases by 25 min. There were no postoperative complications such as bleeding, abdominal abscess, spleen necrosis. The platelet counts of all patients were 〈500 × 10^9/L 3 weeks after operation. Conclusions Intermittent splenic artery occlusion combined with gelatin sponge oppression to hemostasis in Ⅰ or Ⅱ grade of iatrogenic splenic injury was safe and effective.

关 键 词：医源性脾损伤 间歇性脾动脉阻断 

分 类 号：R657.6[医药卫生—外科学]