脾动脉结扎合并脾修补治疗外伤性脾破裂

SPLENIC ARTERY LIGATION PLUS SPLENORRHAPHY IN TREATMENT OF TRAUMATIC SPLENIC RUPTU RE

采用脾动脉结扎合并脾修补治疗32例外伤性脾破裂，所有病人保脾成功，效果良好。并发症是可以接受的，仅4例并发症均为非致命性的，无一例发生脾梗塞或再出血。所有病人均治愈出院，住院天数为9～21天。经随访1～3年，均无脾梗塞和其它异常。详尽阐述了本手术的优点、方法、适应证和手术注意事项以及解剖学上的可行性，并作出了临床评价。认为在选择的病人，脾动脉结扎合并脾修补治疗Ⅰ—Ⅲ级外伤性脾破裂是安全可靠、高度有效的。

In the 9-year period ending December 1996, splenic artery ligation plus splenorrhaphy was performed upon 32 patients with blunt splenic injuries. The causative mechanism was motor vehicular in 16,fall in 12,assault in four. There were 8 Class Ⅰ, 16 Class Ⅱ and 8 Class Ⅲ splenic injuries. Splenic salvage was achieved in all patient. Complications occurred in 4 patients. No patient had splenic infarction or rebleeding. There was no operative death in this group. All patients have recovered well after the operation. The operation produced an excellent effect in the treatment of traumatic splenic rupture. we suggest that patients with Class Ⅰ- Ⅲ splenic injuries after blunt trauma are candidates for the operation if there is:①hemodynamic instability after initial fluid resuscitation;②no associated abdominal organ injuryl ③no pathologic change in the spleen itself. we believe the operation is safe and effective in selected patients with Class Ⅰ- Ⅲ traumatic injuries of the spleen.