脾部分切除治疗105例外伤性脾破裂  

Experiences in partial splenectomy for the treatment of 105 cases with splenic injuries

作　　者：蔡志民[1] 马宏敏[1] 刘全达[2] 杨新华[1] 

机构地区：[1]第三军医大学附属西南医院普通外科,重庆400038 [2]第三军医大学附属西南医院全军肝胆外科研究所,西南肝胆外科医院,重庆400038

出　　处：《第三军医大学学报》2003年第16期1476-1478,共3页Journal of Third Military Medical University

摘　　要：目的　总结脾部分切除术治疗脾脏外伤的临床经验。方法　对本院 16年间 10 5例实施脾部分切除治疗脾外伤的病人进行回顾性分析 ,重点分析脾部分切除术的适应证、手术方法和临床疗效。结果　 67例 ( 63 8% )为单纯性脾脏外伤。按脾脏损伤程度分级标准 ,Ⅰ级脾外伤 13例 ( 11 4% ) ,Ⅱ级 5 6例 ( 5 3 3 % ) ,Ⅲ级 2 8例 ( 2 6 7% ) ,Ⅳ级 8例 ( 7 6% )。术式包括 :脾段切除 4l例、半脾切除 3 5例、次全脾切除 2 9例 ,对儿童脾外伤附加自体脾组织移植 2 1例。全组病例无手术死亡 ,术后膈下积液和感染 3例 ,均经保守治疗治愈。Objective To summarize the clinical experiences in partial splenectomy for the treatment of splenic injuries Methods The indications, surgical procedures and surgical outcomes of a total of 105 cases undergoing partial splenectomy for splenic injuries in Southwest Hospital in the past 16 years were analyzed retrospectively Results Sixty seven cases(63 8%) suffered from isolated splenic injury According to splenic injury scale, grade Ⅰ (13, 11 4%), grade Ⅱ (56, 53 3%), gradeⅢ (28, 26 7%) and grade Ⅳ(8, 7 6%) were found in 105 cases of splenic injuries Surgical procedures included segmental splenectomy in 41 cases, hemi splenectomy in 35 cases, subtotal splenectomy in 29 cases and autotransplantation of splenic tissue in 21 cases of splenic injury in children There was no in hospital death in all cases Severe complications of subdiaphragmatic fluid collection and infection occurred in 3 cases, but the patients were cured by conservative treatment Conclusion Partial splenectomy is a safe and reasonable choice for selected patients with splenic injury

关 键 词：脾脏 外伤性脾破裂 脾切除术 部分切除 手术治疗 

分 类 号：R615[医药卫生—外科学] R657.62[医药卫生—临床医学]