【摘要】 目的探讨非手术治疗脾外伤的可行性及其适应证。方法回顾性分析1995年1月至2004年12月间收治的68例脾外伤非手术治疗的临床资料及其治疗结果。结果本组平均年龄36岁(其中21例>55岁),均经CT检查明确诊断,其中Ⅰ级损伤27例,Ⅱ级损伤35例,Ⅲ级损伤4例,Ⅳ级损伤2例,18例有合并伤,其中2例合并脑外伤。3例非手术治疗失败中转行脾切除术,其中2例为Ⅱ级损伤在治疗第3天和第4天发生迟发性出血,另1例为Ⅳ级损伤,在第5天血肿增大中转手术。结论选择性非手术治疗是治疗脾外伤的一种安全有效的治疗手段,腹腔外器官合并伤及患者的年龄并不影响非手术治疗的成功。更多还原

【Abstract】 Objective To analyze the feasibility and indications of non-surgical management for splenic trauma.Methods From January 1995 to June 2004,68 consecutive patients with splenic trauma were managed non-surgically and the clinical data of these patients were reviewed retrospectively.Results Mean age of patients was 68 years old and 21 patients aged >55 years.According to abdominal CT scans,27 patients had grade Ⅰ injuries,35 grade Ⅱ injuries,4 had grade Ⅲ injuries and 2 grade Ⅳ injuries.In 18 patients with complicated injuries,2 had head injuries.Non-surgical management failed in 3 patients and they converted to splenectomy:delayed bleeding in 2 cases of grade II injuries and expending hematoma in one case of grade Ⅳ injuries.Conclusion Non-surgical management of splenic trauma is feasible and safe in a selected group of patients,independent of the associated injuries and the age of the patients.更多还原