外伤性脾破裂24例的脾部分切除手术操作方法分析

Analysis of the operative procedures in 24 partial resections of injured spleen

目的总结外伤性脾破裂行脾部分切除的手术操作经验。方法回顾1999年3月至2005年7月因外伤性脾破裂行脾部分切除术的24例病人的临床资料，分析病人的一般情况、手术方式，对其中6例手术失败的病人总结经验，改进手术操作技巧。结果6例中转改脾脏全切术，18例顺利完成了脾部分切除术，在出院前行彩超检查，提示全部病例残脾动静脉血流通畅，无脾坏死。结论在熟悉脾脏血管解剖，熟练掌握手术技巧后。

Objective To summarize the experience of the partial resection of injured spleen. Method The clinical data of 24 spleen traumatic rupture patients who experienced partial resection of spleen from March 1999 to July 2005 were reviewed. The essential situation and modus operandi of patients were analyzed Moreover, the six abortive operations were analyzed and the operative procedure skill was improved. Result Six patients＇ operations were failure and 18 spleen partial excisions were successful. Through BUS examinations prior to discharge, all patients＇ remain spleens were not necrosis and the blood current is unobstructed. Conclusions Handling the anatomy of blood vessel of spleen and grasping skill of operation, the achievement ratio of the operation will go up.