脾切除加自体脾片移植术治疗外伤性脾破裂的综合效果观察

目的]探讨脾切除加自体脾片移植术治疗临床外伤性脾破裂的综合效果。方法]对本院自2006年4月至2013年4月收治的178例外伤性脾破裂患者采用脾切除加自体脾片移植术的病例资料作为观察组，同时选择同一时期单纯采用脾切除治疗外伤性脾破裂的158例患者资料作为对照组进行对比分析，统计比较两组患者IgG、IgM、C3、C4、CD3、CD4以及 CD4/CD8值的变化。结果]观察组与对照组患者的 IgG 值分别为（9．47±3．28）g/L、（6．53±2．47）g/L ；Ig M值为（1．53±0．68）g/L、（0．21±0．20）g/L ；C4值为（0．21±0．11）g/L、（0．06±0．05）g/L ；CD3值为（1328．45±148．97）、（1132．59±130．38）；CD4值为（771．33±76．01）、（643．98±43．72）；两组各项指标相比较差异均有显著性（ P ＜0．05）；观察组并发症发生率、术后感染发生率均低于对照组，且差异有显著性（ P ＜0．05）。结论]脾切除加自体脾片移植术治疗外伤性脾破裂安全性、有效性、可行性较高，与单纯脾切除术比较，保留了脾脏的功能，避免术后严重感染及严重并发症的发生，是临床上综合治疗的有效方式。

Observation of Comprehensive Efficacy of Splenectomy Combined with Autologous Splenic Trans-plantation for the Treatment of Traumatic Splenic Rupture

Objective] To explore the comprehensive efficacy of splenectomy combined with autologous splenic transplantation for the treatment of clinical traumatic splenic rupture .Methods]A total of 178 patients with trau-matic splenic rupture undergoing splenectomy combined with autologous splenic transplantation in our hospital from 2006 to 2013 were chosen as the observation group ,and 158 patients with traumatic rupture undergoing with simple splenectomy at the same period were chosen as the control group .Clinical data were compared between two groups .The changes of IgG ,IgM ,C3 ,C4 ,CD3 ,CD4 and CD4/CD8 in two groups were taken for statistical anal-ysis .Results] The IgG values of observation group and control group were （9 .47 ± 3 .28）g/L and （6 .53 ± 2 .47） g/L respectively ,and IgM values were （1 .53 ± 0 .68）g/L and （0 .21 ± 0 .20）g/L respectively ,and C4 values were （0 .21 ± 0 .11）g/L and （0 .06 ± 0 .05）g/L respectively ,and CD3 values were （1328 .45 ± 148 .97） and （1132 .59 ± 130 .38） respectively ,and CD4 values were （771 .33 ± 76 .01） and （643 .98 ± 43 .72） respectively .There was sig-nificant difference in each index between two groups （ P〈0 .05） .The incidence rates of complications and postop-erative infection in observation group were lower than those in control group ,and there was significant difference（ P 〈0 .05） .Conclusion]Splenectomy combined with autologous splenic transplantation for the treatment of trau-matic rupture has high safety ,efficacy and feasibility .Compared with simple splenectomy ,it retains spleen func-tion and avoids the occurrence of severe postoperative infection and complications .Therefore it is an effective com-prehensive treatment method in clinical practice .