外伤性脾破裂非手术治疗的探讨

Discussion on Conservative Treatment for Traumatic Splenic Broken

目的 探讨外伤性脾破裂非手术治疗的可行性。方法 对采用非手术治疗的 36例脾破裂的临床资料进行回顾性分析。结果 本组 36例外伤性脾破裂非手术治疗成功 2 8例 (77.7% ) ,其余 8例在非手术治疗期间因血液动力学指标不稳定或延迟性出血而中转手术 ,亦成功治愈。 2 8例非手术治疗病人 ,术后 3个月CT检查示脾损伤均已愈合。结论 在严格掌握适应证的原则下 ,外伤性脾破裂可采用非手术治疗 ,但必须密切观察病情变化 ,如血液动力学指标不稳定或发生延迟性出血 ,应立即中转手术治疗。

Objective To discuss the feasibility of non-operative treatment of traumatic splenic broken. Methods The clinical data of 36 cases of splenic broken was analyzed retrospectively with non-operative therapy. Results 28 of 36 cases were successfully treated with non-operation and 8 cases were observed in hemodynamic data at unstable and delayed bleeding then further operation were taken successfully. The splenic trauma was healed in 28 cases after 3 months CT scan. Conclusion Under strictly indication, traumatic splenic broken could be treated with non-operation. But closed observation should be taken to decide the operation when unstable hemodynamic or delayed bleeding.