脾叶动脉结扎联合止血纱布填塞在脾破裂中的应用  

Application of splenic lobar artery ligation combined with hemostatic gauze in splenic rupture

作　　者：倪忠鹏 张昕辉[2] 刘养岁[2] 李正臣 赵新[2] 王晓川[2] Ni Zhongpeng;Zhang Xinhui;Liu Yangsui;Li Zhengchen;Zhao Xin;Wang Xiaochuan(Graduate School of Xuzhou Medical University, Jiangsu Xuzhou 221004,China;Department of Hepatobiliary Surgery, Xuzhou Central Hospital, Jiangsu Xuzhou 221002,China)

机构地区：[1]徐州医科大学研究生院,江苏徐州221004 [2]徐州市中心医院肝胆外一科,江苏徐州221002

出　　处：《腹部外科》2019年第4期261-264,269,共5页Journal of Abdominal Surgery

摘　　要：目的探讨脾叶动脉结扎联合可吸收止血纱布填塞在脾损伤出血中保脾的效果及安全性。方法选择2013年3月至2018年5月在徐州市中心医院行手术治疗的脾损伤病例共73例,根据术式不同分为保脾组(22例)和切脾组(51例),保脾组采用脾叶动脉结扎联合可吸收止血纱布填塞法,切脾组采用常规脾切除术,对比两组病人的手术相关指标。结果两组均成功完成手术,保脾组术后发热(3/22)、血栓形成(2/22)等术后并发症发生率低于切脾组(24/51,16/51),术后1周血小板值较切脾组更低,差异有统计学意义(P<0.05)。结论脾叶动脉结扎联合可吸收止血纱布填塞法在脾破裂保脾止血中安全可靠、效果显著,能降低术后并发症的发生率,有一定的临床意义。Objective To investigate the effect and safety of splenic artery ligation combined with absorbable hemostatic gauze in preserving spleen in splenic hemorrhage. Methods From March 2013 to May 2018, a total of 73 cases of splenic injury underwent surgical treatment in Xuzhou Central Hospital were selected. According to different surgical methods, the patients were divided into spleen preservation group (22 cases) and spleen resection group (51 cases). The splenic lobe artery ligation combined with absorbable hemostatic gauze packing method was used in the spleen preservation group, and the conventional splenectomy was used in thespleen resection group. The operation-related indexes of the two groups were compared. Results Both groups completed the operation successfully. The incidence rate of postoperative complications such as fever and thrombosis in the spleen preservation group was lower than that in the splenectomy group, and the platelet value was lower at 1 week after operation than that in the splenectomy group, and the difference had statistical significance ( P < 0.05 ). Conclusion The ligation of splenic artery combined with absorbable hemostatic gauze is safe, reliable and effective in the process of spleen rupture and spleen preservation hemostasis, which can reduce the occurrence of postoperative complications and has certain clinical significance.

关 键 词：脾破裂 脾切除术 保脾手术 脾叶动脉 结扎 

分 类 号：R657.62[医药卫生—外科学]