脾外伤患者自体脾片移植的多中心临床研究  

Multicenter clinical research of splenic autotransplantation

作　　者：陈新斌[1] 贺德[1] 王兴群 李荣江 郝俊 许毓敏[1] 胡钶[1] 马广念[1] 

机构地区：[1]深圳市宝安区人民医院普通外科,广东省深圳市518100 [2]深圳市宝安区福永人民医院普通外科 [3]深圳市宝安区中心医院普通外科 [4]深圳市宝安区沙井人民医院普通外科

出　　处：《实用医学杂志》2017年第21期3559-3562,共4页The Journal of Practical Medicine

基　　金：深圳市宝安区科技计划项目(编号:2013040)

摘　　要：目的探讨自体脾片移植术在脾外伤患者中的临床应用价值。方法收集脾外伤患者120例,其中自体脾片移植组72例,切脾组48例,比较两组手术时间、术中出血、术后住院天数、术后并发症发生率及术前和术后不同时期免疫指标的差异。结果自体脾片移植组手术时间长于切脾组(P<0.05),术中出血、术后住院天数及术后并发症发生率与切脾组相比差异无统计学意义。术后1 d两组各免疫指标均较术前明显降低(P<0.05)。术后1周两组各免疫指标均较术后1 d升高(P<0.05)。术后3个月自体脾片移植组各免疫指标恢复至术前水平(P>0.05),且各免疫指标均优于切脾组(P<0.05)。结论脾切除能使机体免疫功能急剧下降,但机体免疫功能短期内可回升至一定水平,行自体脾片移植能使机体免疫功能恢复至术前水平。Objective To investigate the clinical value of splenic autotransplantation in patients withsevere splenic trauma. Methods A prospective case-control study were performed in 120 patients with traumaticspleen rupture including the treatment group 72 patients and the control group 48 patients. The treatment groupwere treated with splenectomy plus spleen autotransplantation and the control group merely under splenectomy.Compare the operation time,operative blood loss,postoperative hospital stay,postoperative complications and theimmune indexes before and different period after operation. Results Autologous spleen transplantation takes moretime than merely splenectomy(P < 0.05),but the operative blood loss,postoperative hospital stay and postopera-tive complications were no significant difference. 1 days after operation,the immune indexes of two groups weresignificantly lower than those before operation(P < 0.05),and 1 week after operation the immune indexes of twogroups were significantly elevated(P < 0.05). The immune indexes of the treatment group were better than those ofthe control group 3 months after operation(P < 0.05),and there was no significant difference compared withpreoperative. Conclusion Splenectomy cause the decrease in the immune function,but the immune function canquickly rise to a certain level in short term. The splenic autotransplantation can effectively restore the immune func-tion to the preoperative level.

关 键 词：脾破裂 脾切除 脾切除后凶险性感染 自体脾片移植 免疫功能 

分 类 号：R657.6[医药卫生—外科学]