超声显像对创伤性脾破裂自体移植脾生长与存活的监测(英文)

背景:目前,在处理创伤性脾破裂的同时多主张作脾组织块自体移植,对自体移植脾的监测,已有核素检查及免疫学检查等方面的文献,利用超声显像进行随访的报道较少。目的:探讨超声显像监测自体移植脾存活与生长的价值。设计、时间及地点:回顾性病例分析,于2000-01/2004-12在深圳市第二人民医院超声科完成。对象:选择本院行脾切除加自体脾组织移植创伤性脾破裂患者18例,男13例,女5例,年龄20～42岁。方法:取自体未损伤的脾组织,制成面积[(2～4)cm×(1～3)cm]]及厚度≤0.5cm薄片,移植于脾切除者大网膜血管丰富区,自下而上折叠成直径为5cm两侧缝严的袋中。18例自体脾组织移植患者,分别于移植后3,6及12个月行超声检查,并于12个月时行99Tcm-热变性红细胞显像。主要观察指标:核素检查监测脾组织的存活及生长情况。结果:18例中14例自体移植脾片存活并逐渐生长,移植脾呈与正常脾相似的低回声,轮廓规则,边界清楚,内部可见血流信号。4例存在副脾者未见脾片生长。结论:超声显像可成为自体移植脾存活与生长情况准确监测的方法之一。

Ultrasonic visualization of splenic autotransplant survival and growth following traumatic splenic rupture

BACKGROUND: Splenic autotransplantation has been presently involved in the treatment of traumatic splenic rupture. Yhere have been retoorts regarding nuclein examination and immunologic test used to monitor splenic autotransplant. But little is known about ultrasonic visualization for follow up of splenic autotransplant. OBJECTIVE: To investigate the value of ultrasonography in monitoring splenic autotransplant survival and growth. DESIGN, TIME AND SETTING: The present retrospective case analysis Was performed at the Department of Ultrasonography. Shenzhen Second People's Hospital between January 2000 and December 2004.PARTICIPANTS:Eighteen patients undergoing splenectomy and suffering from traumatic splenic rupture,13 males and 5 females. aged 20-42 years, were included for this study. METHODS: Non-injured autologous splenic tissue was prepared into thin sections with an area of(2-4)cm×(1-3)cm and a thickness of≤0.5 cm. And transplanted into the greater omentum with abundant vessels in patients undergoing splenectomy.A1118 patients received ultrasonography at 3,6,and 12 months after splenic transplantation, and were subjected to spleen imaging with99Tcm-heat damaged red blood cells. MAIN OUTCOME MEASURES: Nuclein examination of splenic autotransplant survival and growth. RESULTS: Splenic autotransplants survived and gradually grew in 14 of 18 patients. Splenic autotransplants exhibited low level echo similar to normal spleen, regular contour, clear boundary, and visible internal blood flow signal. Splenic autotransplants were not found growing in 4 patients with accessory spleen. CONCLUSION: Ultrasonography can precisely monitor splenic autotransplant survival and growth.