PASE治疗单纯性Ⅲ、Ⅳ级创伤性脾破裂伴失血性休克的效果及对免疫功能的影响  

Effect of PASE in the treatment of simple grade Ⅲ and Ⅳ traumatic splenic rupture with hemorrhagic shock and its influence on immune function

作　　者：张玉新 闫金亮[1] 田景中[1] ZHANG Yuxin;YAN Jinliang;TIAN Jingzhong(Department of Emergency Surgery,Bozhou People’s Hospital,Anhui Province,Bozhou,236800,China)

机构地区：[1]安徽省亳州市人民医院急诊外科,安徽亳州236800

出　　处：《中国医药导报》2021年第31期111-114,共4页China Medical Herald

摘　　要：目的探讨脾动脉栓塞术(PASE)治疗单纯性Ⅲ、Ⅳ级创伤性脾破裂伴失血性休克的效果及对免疫功能的影响。方法回顾性分析2017年6月至2020年12月安徽省亳州市人民医院收治的86例单纯性Ⅲ、Ⅳ级创伤性脾破裂伴失血性休克患者的临床资料,按照手术方式不同分为观察组和对照组,各43例。对照组采用传统手术治疗,观察组采用PASE治疗。比较两组围手术期情况、T淋巴细胞亚群指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))的变化以及并发症发生率。结果观察组手术时间、收缩压恢复时间、下床活动时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)组间、时间及交互作用比较差异均有统计学意义(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论PASE治疗单纯性Ⅲ、Ⅳ级创伤性脾破裂伴失血性休克患者的效果明显,值得推广。Objective To investigate the effect of partial splenic artery embolization(PASE)in the treatment of simple gradeⅢandⅣtraumatic splenic rupture with hemorrhagic shock and its influence on immune function.Methods The clinical data of 86 patients with simple gradeⅢandⅣtraumatic splenic rupture complicated with hemorrhagic shock admitted to Bozhou People’s Hospital of Anhui Province from June 2017 to December 2020 were retrospectively analyzed,according to the operation method,they were divided into observation group and control group,with 43 cases in each group.The control group was treated with traditional surgery,and the observation group was treated with PASE.The perioperative situation,the changes of T lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),and the incidence of complications were compared between the two groups.Results The operation time,systolic blood pressure recovery time,ambulation time,and hospitalization time in the observation group were shorter than those in the control group,and the intraoperative blood loss of the observation group was less than those in the control group,and the differences were statistically significant(P<0.05);the differences of CD3^(+),CD4^(+),CD4^(+)/CD8^(+) between the two groups,time point and interaction compared were statistically significant(P<0.05);the total incidence of complications the obseruation group was lower than that of the control group(P<0.05).Conclusion PASE in treatment of simple gradeⅢandⅣtraumatic splenic rupture with hemorrhagic shock have obvious effect,which is worth promoting.

关 键 词：创伤性脾破裂 失血性休克 脾动脉栓塞术 免疫功能 

分 类 号：R657.62[医药卫生—外科学]