外伤性脾破裂切除加自体脾移植分析

Analysis of splenectomy for traumatic splenic rupture and splenic autotransplantation

目的分析外伤性脾破裂切除加自体脾移植的疗效。方法回顾性分析本院采取脾破裂切除加自体脾移植术治疗的外伤性脾破裂患者资料,并与同期采取单纯脾破裂切除术治疗的患者进行疗效对比分析。结果对照组IgG、IgM、C3、C4、CD3、CD4、CD4/CD8分别为(6.62±2.48)g/L、(0.27±0.24)g/L、(0.47±0.30)g/L、(0.07±0.07)g/L、(1133.81±131.23)μl、(646.19±43.53)μl、(0.56±0.32)μl;观察组则分别为(9.43±3.56)g/L、(1.58±0.69)g/L、(0.83±0.21)g/L、(0.19±0.10)g/L、(1309.79±150.39)μl、(767.18±75.40)μl、(1.07±0.28)μl;观察组各项观察指标均显著高于对照组(P<0.01),观察组患者术后免疫力显著优于对照组。两组均无死亡病例报告,观察组严重并发症发生率与术后暴发性感染(OPSI)的发生率均明显少于对照组(P<0.05)。结论脾破裂切除加自体脾移植术是一种良好的保脾手术方式,对不符合行单纯脾切除手术的患者应尽量采取此种术式,以提高患者预后生活质量。

Objective To analyze the clinical effect of splenectomy for traumatic splenic rupture and splenic autotransplantation.Methods Of 49 patients with traumatic splenic rupture,28 were treated with splenectomy and splenic autotransplantation（the study group）,while the other 21 received splenectomy alone（the control group）.The clinical efficacy were compared between the two groups.Results The levels of IgG,IgM,C3,C4,CD3,CD4,CD4/CD8 of the control group was（6.62±2.48） g/L,（0.27±0.24） g/L,（0.47±0.30） g/L,（0.07±0.07） g/L,（1133.81±131.23） μl,（646.19±43.53） μl,（0.56±0.32） μl,respectively.The values of the study group was（9.43±3.56） g/L,（1.58±0.69） g/L,（0.83±0.21） g/L,（0.19±0.10） g/L,（1 309.79±150.39） μl,（767.18±75.40） μl,（1.07±0.28） μl,respectively.No case of death was found in the two groups.The incidences of severe complications and over-whelming post-splenectomy infection（OPSI） were significantly higher in the study group than the control group（P0.01）.Conclusion Splenectomy combined with splenic autotransplantation is a good way of spleen-preserving,especially for patients that not meet the standards of simple splenectomy in order to improve the life quality of patients.