介入栓塞术对创伤性脾破裂止血效果及预后的影响研究  

Study on the Effect of Interventional Embolization on Hemostasis and Prognosis of Traumatic Splenic Rupture

作　　者：许兴杰 林世安 郑剑志 XU Xingjie;LIN Shian;ZHENG Jianzhi(Department of Vascular Surgery,Dehua County Hospital,Quanzhou 362500,China)

机构地区：[1]德化县医院血管外科,泉州362500

出　　处：《中国医药指南》2024年第24期33-35,共3页Guide of China Medicine

摘　　要：目的探讨介入栓塞术在创伤性脾破裂止血中的效果及预后,为临床提供参考。方法回顾性研究2021年10月至2023年10月我院接治的22例创伤性脾破裂出血患者的临床资料。根据临床手术方式不同分为介入术组和外科术组,分别为7例和15例。其中,外科术组采取全脾切除术,介入术组采取经导管脾动脉栓塞术(TAE)治疗,对比分析两组的手术时间、术中出血量、术后住院时间、术后恢复进食时间及首次下地活动时间,并分析术中输血及止血成功,掌握术后并发症发生率。结果两组手术时间无显著性差异(P>0.05),介入术组术中出血量、术后住院时间、术后恢复进食时间以及首次下地活动时间均低于外科术组(P<0.05)。介入术组术中输血率为42.86%,术后无输血,外科术组分别为100%、20%,差异有统计学意义(P<0.05);两组止血成功率均为100%(P>0.05)。介入术组术后并发症发生率为14.38%,低于外科术组的33.33%(P<0.05)。结论介入栓塞术治疗创伤性脾破裂出血有着创伤小、术中术后输血少、术后恢复快及并发症少的优势,整体优于脾脏切除术。Objective To explore the effect and prognosis of interventional embolization in hemostasis of traumatic splenic rupture,and provide reference for clinical practice.Methods Retrospective study on clinical data of 22 patients with traumatic splenic rupture and bleeding treated our hospital from October 2021 to October 2023.According to different clinical surgical methods,there were 7 cases in the intervention group and 15 cases in the surgical group,respectively.Among them,the surgical group underwent total splenectomy while the interventional group underwent transcatheter splenic artery embolization(TAE)treatment.The surgical time,intraoperative blood loss,postoperative hospital stay,postoperative food recovery time,and first time to go to the ground activity time of the two groups were compared and analyzed,and the success of intraoperative blood transfusion and hemostasis was analyzed to grasp the incidence of postoperative complications.Results There was no significant difference in surgical time between the two groups(P>0.05).The intraoperative bleeding volume,postoperative hospitalization time,postoperative recovery time for eating,and first ground activity time in the intervention group were all lower than those in the surgical group(P<0.05).The intraoperative blood transfusion rate in the intervention group was 42.86%,and there was no blood transfusion after surgery.The surgical group had 100%and 20%,respectively,and the difference was statistically significant(P<0.05).The success rates of hemostasis in both groups were 100%(P>0.05).The incidence of postoperative complications in the intervention group was 14.38%,significantly lower than 33.33%in the surgical group(P<0.05).Conclusions Interventional embolization for the treatment of traumatic splenic rupture and bleeding has the advantages of minimal trauma,less intraoperative and postoperative blood transfusion,fast postoperative recovery,and fewer complications.Overall,it is superior to splenectomy.

关 键 词：介入栓塞术 外科术 脾脏破裂 止血 预后 

分 类 号：R657.62[医药卫生—外科学]