脾切除同步自血回输治疗闭合性脾破裂大出血探讨

Clinical effects of synchronous blood auto-infusion during splenctomy in the treatment of hemorrhoea caused by closed spleen rupture

目的探讨脾切除同步自血回输治疗闭合性脾破裂大出血的应用价值。方法2003至2006年间收治的32例外伤性脾破裂出血行脾切除术患者,其中18例采用脾切除同步自血回输,14例异体输血脾切除术。比较两组术中出血量、手术前后血细胞学和凝血相关指标的变化,术后1、3、5d的丙氨酸转氨酶(GPT)变化,术后住院天数。结果脾切除同步自血回输组术后住院天数,术后1、3、5d的GPT低于异体输血脾切除术组(P<0.05)。术中出血量、手术前后血红蛋白变化值两组差异无统计学意义(P>0.05)。输血后血细胞学各项检查指标较输血前均有明显提高(P<0.05)。结论脾切除同步自血回输技术达到输血目的,而且操作简便,减少了肝功能损害及机体的急性损伤,缩短了术后住院天数,提高了外伤性脾破裂出血脾切除的治疗效果。

Objective To explore the application value of synchronous blood auto - infusion during splenctomy in the treatment of hemorrboea caused by closed spleen rupture . Methods 32 cases of spleen traumatic rapture received splenectomy from 2003 to 2006 in our hospital , among them , 18 had synchronous blood auto - infusion during splenctomy , 14 had foreign blood infusion during splenctomy. Blood loss during operation , related index of hemecytology and coagulation before and after opemtion,GPT change of 1,3,5 days postoperatively ,hospital day were compared . Results Hospital days and GPT change of 1,3,5 days postoperatively were lower in the blood auto - infusion group than those in the foreign blood infusion group （ P 〈 0.05）, there was significant difference in no blood loss during operation and hemoglobin change before and after operation between the two groups（ P 〉 0.05 ） . The various index of hemocytology were all significantly improved after blood infusion compared with those before blood infusion（ P 〈 0.05） . Conclusions Synchronous blood auto- infusion during splenctomy can achieve the goal of blood infusion and the procedure is simple. It induces the impairment of liver function and acute injury to the whole body , also it shortens the postoperative hospital days, so it can improve the therapeutic effects of splenctomy in the treatment of hemon＇hoea caused by spleen traumatic rupture .