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43例外伤性脾破裂的治疗体会

Experience in the treatment of traumatic rupture of spleen(A report of 43 cases)

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【作者】 侯远发赵海生宋耀明

【Author】 HOU Yuan-fa,ZHAO Hai-sheng,SONG Yao-ming,Department of surgery,The People’s Hospital of Yunfu,Yun fu,Guang dong 527300

【机构】 广东省云浮市人民医院外科广东省云浮市人民医院外科 527300527300

【摘要】 目的总结外伤性破裂的治疗方法与经验。方法对我院1995~2004年12月外伤性脾破裂43例患者资料进行回顾性分析,其中40例患者进行剖腹探查,术中行脾修补术13例,脾部分切除术9例,全脾切除13例,脾切除加自体脾脏移植术5例,3例在严密观察下行保守治疗。结果2例脾破裂患者术后因合并颅脑损伤和严重复合伤死亡,41例患者痊愈出院。结论遵循“抢救生命第一,保留脾脏第二”的原则,根据脾损伤伤情及病人的全身情况去选择手术方式,分别施行脾修补术,部分脾切除术,全脾切除术,全脾切除术加自体脾片移植术。如果伤情允许术中尽量保留器官,对不能保脾的伤者可行脾片移植术以保术后病人有良好的免疫功能。

【Abstract】 Objective To summarize the experiences in the treatment of traumatic rupture of spleen.Methods From June 1995 to December 2004,43 cases with traumatic rupture of spleen were analyzed retrospectively.Results 4l cases with traumatic rupture of spleen were cured,2 cases died from severe craniocerebral injury and severe combined injuries respectively.Conclusion Principle of treatment which saving life is the first and saving spleen is the second for treating the traumatic rapture of spleen.According to patient’s traumatic status and general condition,the splenic repair,partial splenectomy,total splenectomy and total splenectomy plus autotransplantation of splenic piece can be selected respectively.If conditions are permitted,the spleen is reserved as far as possible during operation.As to the spleen can not be reserved,the splenic piece transplantation should be performed for keeping the immunologic function.

【关键词】 脾破裂脾切除外伤
【Key words】 Rupture of spleenSplenectomyTrauma
  • 【文献出处】 岭南现代临床外科 ,Lingnan Modern Clinics in Surgery , 编辑部邮箱 ,2006年01期
  • 【分类号】R657.62
  • 【被引频次】2
  • 【下载频次】24
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