脾修补术、非手术疗法治疗腹部闭合性损伤脾破裂效果  

Effect of Splenic Repair and Non-operative Therapy on Rupture of Spleen After Abdominal Closed Injury

作　　者：李敬业[1] LI Jingye(Department of General Surgery,Xiamen Third Hospital,Xiamen Fujian 361100,China)

机构地区：[1]厦门市第三医院普外科,福建厦门361100

出　　处：《中国卫生标准管理》2021年第20期46-49,共4页China Health Standard Management

摘　　要：目的探究在腹部闭合性损伤脾破裂治疗中采用非手术疗法和脾破裂缝合修补的临床疗效。方法筛选厦门市第三医院2016年1月—2020年6月收治的80例腹部闭合性损伤脾破裂患者,根据病情程度分为观察组(45例,采用脾破裂缝合修补)和对照组(35例,采用非手术疗法),比较两组患者的临床疗效、不良反应发生率、住院时间和复发情况。结果实施治疗干预后,观察组的不良反应发生率为4.44%,显著低于对照组的28.57%,差异有统计学意义(P<0.05);观察组的治疗成功率为93.33%,平均住院时间(8.52±1.05)d,复发1例,综合情况显著优于对照组,差异有统计学意义(P<0.05)。结论在治疗腹部闭合性损伤脾破裂患者时,采用手术治疗为首要原则,尤其是明确诊断和高度疑似的患者,首选手术缝补治疗,而对于部分轻度存疑的患者,采用非手术疗法也具有一定可行性。临床医师应在治疗过程中对症治疗,给予患者合适的治疗方式,提高患者的远期生存质量,改善其预后状况。Objective To explore the clinical efficacy of non-surgical therapy and suture repair of spleen rupture in the treatment of abdominal closed injury.Screening Methods A total of 80 patients with closed abdominal injury and splenic rupture admitted to Xiamen Third Hospital from January 2016 to June 2020,according to the extent of the disease were divided into observation group(45 cases,the use of spleen rupture suture repair)and control group(35 cases,the use of nonsurgical therapy),to compare the clinical efficacy of two groups of patients,the incidence of adverse reactions,length of hospital stay and relapse.Results After treatment and intervention,the incidence of adverse reactions was 4.44%,which was significantly lower than 28.57%of the control group,and the difference was statistically significant(P<0.05).The treatment success rate of the observation group was 93.33%,average length of hospital stay was(8.52±1.05)d,and the recurrence rate was 1 case.The comprehensive situation was significantly better than that of the control group,with statistically significant difference(P<0.05).Conclusion In the treatment of spleen rupture in patients with closed abdominal injuries,the surgery as the first principle,especially clear diagnosis and highly suspected patients,can be treated by surgical mending,first for some mild patients with non-surgical therapy has a certain feasibility of doubt,the clinician should be in the process of treatment,symptomatic treatment,giving patients appropriate treatment,improve the quality of the long-term survival of patients and improve the prognosis.

关 键 词：腹部 闭合性损伤 脾破裂 非手术疗法 缝合修补 不良反应 

分 类 号：R657.6[医药卫生—外科学]