创伤性脾破裂非手术治疗探讨

Experience in nonoperative management of adult splenic injury

目的探讨闭合性腹部外伤致脾破裂非手术治疗的可行性。方法对我院2003～2006年间收治的27例外伤性脾破裂患者的临床资料进行回顾性分析。结果8例患者行非手术治疗,占同期脾破裂患者的29.6%。其中1例非手术治疗失败后急症行脾切除+小肠破裂修补手术。7例非手术治疗患者均痊愈出院,平均住院时间为12天,出院随访3个月均恢复良好。结论选择合适的脾破裂患者行非手术治疗,是安全、有效的。

Objective To summarize the experience in nonoperative management of adult blunt splenic injury. Methods Twenty-seven cases of adult splenic injury having been managed operatively or nonoperatively from 2003 to 2006 in a monitored setting were analysed. Results Eight patients were treated by nonoperative management amounting to 29.6% （8/27） in this period, nonsurgical therapy failed in one patient.This patient was caused with part small intestine excision and splenic excision in emergent operation. Seven patients underwent nonoperation were followed up for 3 months and had no complications noted. The mean length of hospitalization was 12 days. Conclusion Selective nonoperative management in adult patients with splenic injury can be done safely in a monitored setting.