腹膜后带蒂脾移植在严重脾外伤保脾手术中的应用

Clinical Application of Retroperitoneal Splenic Auto transplantation in Treatment of Severe Splenic Injury

目的探讨自体腹膜后带蒂脾移植在严重脾外伤保脾手术中应用的可行性及价值。方法对9例严重脾外伤病人保留脾上下极带血管蒂的脾片（或脾块）,就近腹膜后造穴植入。以患者术前的情况为对照,在术后3-12个月观察移植脾彩超、核素扫描、血常规、血小板及IgM、IgG、补体C3水平。结果9例病人术后彩超、同位素扫描（99m锝）随访观察,移植的脾组织显像清晰,血常规、血小板及IgM、IgG、补体C3均维持正常水平。结论腹膜后自体带蒂脾移植能够长期存活并能维持一定的免疫功能,在临床上推广应用是可行的。

Objective To evaluate the feasibility and clinical results of retroperitoneal splenic autotransplantation in treatment of severe splenic injury.Method 9 Patients with severe splenic injury were transplanted with pedicled autosplenic tissue in retroperitoneal cavity formed by operation.Ultrasound and 99mTc scanning of the transplanted splenic tissue,blood routine,platelet,serum IgM,IgG and complement C3 levels in patients were observed 3 to 12 months after operation,and compared with those before operation.Results Color-ultrasnography and ^99mTc scanning showed that the remnant splenic tissue was well visualized in retroperitoneum.Meanwhile,blood routine,platelet,immunoglobulin（IgM,IgG） and C3 were measured in the peripheral blood,and maintained normal levels as preoperation.Conclusion Retroperitoneal pedicled splenic autografts could be alive for a long time and maintain the basic immune function of spleen.