脾切除术胃底损伤的原因及处理

目的：探讨因各种原因的脾切除术引起胃底区胃壁组织损伤的原因、处理方法及预防措施。方法：回顾分析12年来17例胃底损伤的临床资料，对损伤的原因、诊断、处理方法和预防措施进行分析总结。结果：17例胃底损伤中，贲门周围血管离断术＋脾切除11例，单纯脾切除6例。术中发现13例并给予及时处理，术后全部痊愈。4例因术后化脓性腹膜炎再手术发同胃底部坏死穿孔，行手术修补、腹腔引流术，3例死亡（75％），1例痊愈（25％）。结论：清楚的解剖、规范的操作是预防胃底部胃壁组织损伤的关键，及时发现和正确处理对争取良好的预后十分重要。

The Causes and Management of Gastric Fundus Injuries in Splenectomy

Objective: To study the cause, treatment and prevention for gastric fundus injuries in splenectomy due to various kinds of reasons . Methods: The 17 cases of gastric fundus injuries were reviewed retrospectively in past 12 years. The causes, diagnoses, treatment methods and prevention were studied. Results-.In 17 cases, there were 11 cases of transabdominal devas-cularization as well as splenectomy and 6 cases of simple splenectomy. 13 cases found during operation were treated in time and were cured successfully. 4 reoperation cases were found with gastric fundus necrosis and perforation, which were repaired and performed by abdominal cavity drainage. Then 1 cases were cured(25%), 3 case died(75%). Conclusion:In order to prevent the gastric fundus injures, it is critical for doctor to be careful in dissection and perform standard operation. It is also important for good prognosis that gastric fundus injuries should be discovered as soon as possible and be correctly operated in time.