脾损伤行脾保留手术的可行性分析

Feasibility Analysis of Spleen Reservations Surgical Procedure in Spleen Injury

目的:探讨脾损伤后行脾保留的可行性及必要性。方法:59例中单纯粘合剂止血8例(Ⅰ级),单纯缝合修补7例(Ⅰ/Ⅱ级),单纯缝合修补+粘合胶止血15例(Ⅰ/Ⅱ级),脾部分切除6例(Ⅱ/Ⅲ级),脾破裂大网膜捆扎+脾动脉结扎10例(Ⅱ/Ⅲ级),原位保留脾蒂+后腹膜自体脾移植2例(Ⅳ级),脾切除+自体脾组织移植1例(Ⅳ级),DSA下行脾动脉栓塞术(其中部分脾栓塞术PSE7例,脾动脉主干栓塞SAE3例)10例(Ⅰ/Ⅱ/Ⅲ级)。结果:59例脾保留手术均获成功,复查脾组织存活,术后免疫功能指标均正常。结论:脾损伤后行脾保留手术是安全可行的,对于保留和恢复脾脏功能具有重要价值。

Objective To study the feasibility and necessity of the spleen reservation surgical operation in spleen injury. Methods Spleen reservation surgical operation was done in 59 cases of spleen injury, of which eight cases with bleeding adhesion（I- level）, simple suture repair in seven cases（Ⅰ/Ⅱ level）, simple suture repair and adhesion to stop bleeding in 15 cases（Ⅰ/Ⅱ level）, partial spleen removal in six cases（ Ⅱ/Ⅲ level）, omentum banding and splenic artery ligation in 10 cases（Ⅱ/Ⅲ level）, reservation of the spleen pedicle after retro - peritoneal splenic auto- transplantation in two cases（Ⅳ class）, splenectomy and autologous spleen tissue transplantation in one case（Ⅳ- class）, DSA downlink splenic artery embolization（part of PSE： 7 cases, SAE： 3 cases） in 10 cases（Ⅰ/Ⅱ category Ⅲ）. Results All the 59 patients with surgical operations of spleen reservation were successful with survival of the reserved spleen and immune fimction indicators in the normal range. Conclusion Spleen reservation surgical operations are safe and feasible in spleen injury, having great value to reserve and restore the function of the spleen.