选择性脾动脉栓塞术与脾脏修补术用于外伤性脾破裂急诊救治中的效果及对创伤反应与康复情况的影响  

Effects of selective splenic artery embolization and splenorrhaphy in emergency treatment of traumatic splenic rupture and its influences on trauma response and rehabilitation

作　　者：柴新强 魏武运 CHAI Xinqiang;WEI Wuyun(the First People's Hospital of Xianyang,Xianyang 712000;Xi'an Sanqiao Jingcheng Hospital,Xi'an 710086,China)

机构地区：[1]咸阳市第一人民医院,陕西咸阳712000 [2]西安三桥精诚医院,陕西西安710086

出　　处：《临床医学研究与实践》2024年第27期74-77,共4页Clinical Research and Practice

摘　　要：目的探讨选择性脾动脉栓塞术与脾脏修补术用于外伤性脾破裂急诊救治中的效果及对创伤反应与康复情况的影响。方法选取2021年1月至2023年1月收治的70例外伤性脾破裂患者为研究对象,根据手术方案差异将其分为A组和B组,各35例。A组给予选择性脾动脉栓塞术,B组给予脾脏修补术。比较两组的治疗效果。结果A组的手术时间、术后首次排气时间、术后首次下床活动时间及住院时间均短于B组,术中出血量少于B组(P<0.05)。术后,A组的皮质醇(Cor)、醛固酮(ALD)、促肾上腺皮质激素(ACTH)水平低于B组(P<0.05)。术后,A组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于B组(P<0.05)。A组的并发症总发生率低于B组(P<0.05)。结论选择性脾动脉栓塞术与脾脏修补术治疗外伤性脾破裂患者均有较好的手术效果,但前者更有助于缩短手术时间,促进患者术后快速恢复,减少术中出血量,减轻创伤反应,降低对免疫功能的影响及术后并发症发生率。Objective To explore effects of selective splenic artery embolization and splenorrhaphy in emergency treatment of traumatic splenic rupture and its influences on trauma response and rehabilitation.Methods A total of 70 patients with traumatic splenic rupture admitted from January 2021 to January 2023 were selected as the research objects.According to the difference of surgical plan,the patients were divided into group A and group B,with 35 cases in each group.The group A was given selective splenic artery embolization,and the group B was given splenorrhaphy.The therapeutic effects of the two groups were compared.Results The operation time,postoperative first exhaust time,postoperative first ambulation time and hospitalization time of the group A were shorter than those of the group B,and the intraoperative blood loss was less than that of the group B(P<0.05).After operation,the levels of cortisol(Cor),aldosterone(ALD)and adrenocorticotropic hormone(ACTH)in the group A were lower than those in the group B(P<0.05).After operation,the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the group A were higher than those in the group B(P<0.05).The total incidence of complications in the group A was lower than that in the group B(P<0.05).Conclusion Selective splenic artery embolization and splenorrhaphy have good surgical results in the treatment of traumatic splenic rupture,but the former is more helpful to shorten the operation time,promote rapid postoperative recovery of patients,decrease intraoperative blood loss,relieve trauma response,and reduce the impact on immune function and incidence of postoperative complications.

关 键 词：选择性脾动脉栓塞术 脾脏修补术 外伤性脾破裂 创伤反应 康复情况 

分 类 号：R657.62[医药卫生—外科学]