脾脏捆扎术的实验研究

Experimental study on spleen wrapping

目的探讨脾捆扎术在保留脾脏手术中的应用。方法取成年杂种犬16只，随机分为2组，分别于脾脏的上、中、下极模拟脾脏损伤Ⅱ、Ⅰ、Ⅲ级。实验组均采用脾脏捆扎术，对照组分别采用结节缝合加大网膜充填，结节缝合加明胶海绵及部分脾脏切除术。分别观察手术时间，失血量的多少，脾脏的近期和远期形态改变以及脾脏功能变化。结果脾脏上极损伤实验组失血量明显少于对照组（21±6／32±17；P〈0．05），脾脏下极损伤对照组脾脏形态改变和功能变化明显高于实验组（8／1，P〈0．05；8／2；P〈0．05）。结论脾捆扎术是一种非常有效的保脾手术方法，选择性治疗Ⅰ～Ⅲ级外伤性脾破裂远期效果好，安全简便，能最大限度保留脾脏功能。

Objective To investigate the clinical application of wrapping spleen in the operation of retaining spleen. Methods Sixteen adult hybrid dogs were divided into two groups at random. The splenic injury of gradeⅡ ,Ⅰ and Ⅲ were imitated at upper part, middle part and lower part, respectively. Wrapping spleen was equally performed in the experimental group while protuberance suture with colic omentum silting, protuberance suture with sponge and partial splenectomy were adopted, respectively, in the control group. The time of operation, the amount of blood loss and the change of morphology and splenic functions were determined. Results The amount of blood loss in the experimental group was significantly lower than that in the control group （21 ± 6/32 ± 17;P〈0.05） at upper part splenic injury. The change of morphology and splenic functions in the control group were significantly higher than those in the experimental group（8/1, P〈0.05;8/2; P〈0.05） at lower part of splenic injury. Conclusion Wrapping spleen can play an important role in retaining spleen. It is safe and handy to treat selectively traumatic rupture of spleen （grade Ⅰ-Ⅲ） by preserving splenic functions maximally with an excellent prognosis.