ҽԴ��Ƣ���˵ķ������������

目的探讨医源性脾损伤的发生原因和防治措施。方法回顾性分析1992～2002年上海第二医科大学附属宝钢医院26例与手术操作相关的脾损伤病例。结果全组病例均经手术证实，医源性脾损伤发生于结肠手术中占31％(8／26)、胃手术中占27％(7／26)、胰腺手术中占15％(4／26)，其他手术中占27％(7／26)。本组均经手术治愈，其中行单纯脾切除6例，脾切除加自体脾移植2例，脾修补5例，13例应用了局部止血措施。结论良好的麻醉和细致的手术操作可以有效预防医源性脾损伤的发生，而根据伤情合理选择术式是治疗医源性脾损伤的关键。

Prevention and management of iatrogenic splenic injuries

Objective To study prevention and managementof iatrogenic splenic injuries. Methods The data of 26 patients with splenic injuries caused by operations from 1992 to 2002 in Shanghai Baogang Hospital were analyzed retrospectively. Results All cases were confirmed by exploratory laparotomy and they recovered well. The major causes included undergoing operations on colon (8/26), stomach (7/26) and pancreas (4/26). The operation procedures for these cases were simple splenectomy (6/26), splenectomy plus splenic autotransplantation (2/26), simple repair of spleen (5/26) and local hemostasis (13/26) respectively. Conclusion The morbidity of iatrogenic splenic injuries can be reduced by improving the anaesthesia and operative technique. At the same time, it is key to choose the correct surgical management method under different circumstances of iatrogenic splenic injuries.