脾动脉栓塞治疗脾破裂与开腹脾切除的临床比较研究  

Clinic research of splenic artery embolism therapy vs open splenectomy therapy in the treatment of spleen rupture

作　　者：李兵 Li Bing(Emergency department,Taihe County People’s Hospital,Taihe 236600,China)

机构地区：[1]太和县人民医院急诊医学科,太和236600

出　　处：《肝胆外科杂志》2021年第4期276-278,共3页Journal of Hepatobiliary Surgery

摘　　要：目的探讨选择性脾动脉栓塞治疗脾破裂的临床疗效。方法回顾分析我院2017年7月~2021年2月间创伤性脾破裂患者47例,其中24例采用脾动脉栓塞术治疗作为研究组,另外23例接受开腹脾切除治疗的患者作为对照组。分析比较两种不同治疗方式的临床治疗效果。结果两组患者的一般资料比较,无明显差异。脾切除组的损伤分级,三级损伤比例稍高于脾动脉栓塞组。脾动脉栓塞组除了术后发热比例高于脾切除组外,在手术时间、术后卧床时间、术后排气时间、术后腹痛需要止痛治疗比例、住院时间上均优于对照组(P<0.05);脾动脉栓塞组出现一例脾窝脓肿,穿刺引流后治愈;出现一例再出血病例,行开腹脾切除后治愈。结论脾动脉栓塞是治疗外伤脾破裂的有效治疗手段,其具有手术创伤小,术后恢复快,保留脾脏功能等优点,但存在腹腔继发感染形成脓肿以及再次出血等风险。对于脾脏损伤分级较重,脾栓塞后再次出血,仍应果断选择开腹脾切除术。Objective To explore the clinical efficacy of selective splenic artery embolism in the treatment of spleen rupture.Methods Clinic data of 47 patients with traumatic spleen rupture admitted to Taihe County People’s Hospital emergency department from Jul.2017 to Feb.2021 were retrospectively analyzed,Of which 24 patients were treated with splenic artery embolism as a study group and 23 patients received open splenectomy therapy as a control group.The clinical treatment effect of two different treatment methods was analyzed and compared.Results There was no significant difference in the general data of the two groups of patients.The damage classification of the open splenectomy group was slightly higher than that of the splenic artery embolism group.In addition that fever ratio after surgery of the splenic artery embolism group is higher than that of the open splenectomy group.In operation time,postoperative bed time,postoperative exhaust time,postoperative abdominal pain rain that need treatment and hospitalization time,The study group is better than the control group(P<0.05).Conclusion Splenic artery embolism is an effective treatment method for treating the traumatic spleen rupture,which has the advantages of small surgical trauma,rapid recovery after surgery,and retaining spleen function,but there is a risk of abdominal secondary infection to form abscesses and re-bleeding.As to the special patients with a heavier spleen damage classification and bleeding again after splenic artery embolism,open splenectomy is still decisively chosen.

关 键 词：选择性脾动脉介入 开腹手术 介入栓塞治疗 脾破裂 

分 类 号：R659[医药卫生—外科学]