脾切除430例临床分析

目的 分析总结脾切除手术的近期疗效以提高其安全性、降低死亡率，减少并发症并指导正确掌握切脾适应证。方法 统计４３０例脾切除手术病人的临床资料，包括切脾指征、手术种类、术后并发症和手术死亡率。结果 切脾指征中原发疾病以肝脏为最多，占１９２例（４４．６５％），尤其是门脉高压性脾亢１６４例（３８．１５％）；４３０例病人共行７６８例次不同类型的手术，除切脾外，以分流断流为最多，共７５例次（２３．６６％）；

Clinical analysis of 430 patients submitted to splenectomy

Objective To summarize the short-term results of splenectomy operations in order to increase the operative security, decrease the operative morbidity and mortality and correctly master the indications of splenectomy. Methods The clinical data of 430 cases of patients underwent splenectomy, including indications of splenectomy, the types of operation, post-operative morbidity and mortality were collected. Results The most of patients indicated for splenectomy were hepatic diseases (192 cases, 44 65%), especially for portal hypertension splenomegaly (164 cases, 38 15%); 430 cases underwent 786 different types of operation, besides the splenectomy, most of them were portacaval shunt or esophagogastric devascularization (75 cases/times, 23 66%), 111 patients experienced post-operative morbility (25 83%), most of them were infections (11 86%), 12 patients died (mortality 2 8%). Conclusions The major deciding factors in increasing the security of splenectomy are knowing splenic immune functions, mastering indications of splenectomy and appropriately managing of patients perioperatively.