保脾手术治疗外伤性脾破裂47例临床观察

目的 观察保脾手术治疗外伤性脾破裂的可行性及安全性.方法 回顾性分析47例采取保脾手术治疗的外伤性脾破裂患者临床资料,分析其治疗效果.结果 47例患者术后并发感染4例,经换药后均痊愈；术后大出血而再次行脾切除手术1例,并行自体脾大网膜囊内组织片移植术.46例患者保脾手术成功,平均住院时间15 d,无死亡病例.所有患者术后6个月均进行腹部B超或CT复查,证实脾组织生存良好,各项检查指标正常.随访未发生凶险性感染及并发症.结论 保脾手术治疗外伤性脾破裂能最大程度保留脾脏各项功能,安全可行,值得临床上推广应用.

Clinical observation on the spleen-preserving surgery in the treatment of 47 patients with traumatic rupture

Objective To explore the feasibility and safety of the spleen-preserving surgery in the treatment of traumatic rupture. Methods 47 patients with traumatic rupture were treated with spleen-preserving surgery：the biological glue which local physical bleeding had 7 cases ,suture repair had 13 cases ,splenic artery ligation had 10 cases, splenic artery ligation and splenic repair had 9 cases,partial splenectomy had 8 cases. Results 47 patients had four cases of infection, and cured after dressing, 1 case had postoperative bleeding symptoms and used spleneetomy surgery. 46 patients with spleen-preserving operation is successful, the average length of stay was 15 days, there is no deaths. After 6 months, all patients used abdominal B-utrasoundor CT scans to confirm the survival of spleen is good and indicator of the examination is normal. Follow-up of these patients had no dangerous infections and complications. Conclusion Spleen-preserving surgery in the treatment of traumatic rupture was safe, feasible, could retain the greatest degree of function, and could be used in clinical practice.