腹膜后自体脾移植治疗外伤性脾破裂的前瞻性研究

Retroperitoneal splenic autotransplantation for the treatment of traumatic splenic rupture: a prospective study

目的探讨腹膜后自体脾移植在严重脾外伤保脾手术中应用的可行性及价值。方法采用前瞻性病例对照研究,将66例严重脾外伤病人分为腹膜后自体脾移植组例、大网膜自体脾移植组,其中腹膜后自体脾移植组32例,大网膜自体脾移植组34例。观察术后一般情况,术后1天～12个月血常规,血IgA、IgM、IgG、C3、Tuftsin水平变化。结果腹膜后自体脾移植组手术时间短于大网膜自体脾移植组(P<0.05),术后其它一般情况变化、术后1天～12个月血IgA、IgM、IgG、C3、Tuftsin水平两组无统计学差异(P>0.05)。结论腹膜后自体带蒂脾移植术能够保留脾脏的部分免疫功能,且手术操作简便,在临床上推广应用是可行的。

Objective To investigate the clinical feasibility and value of retroperitoneal splenic autotransplantation in severe trauma of the spleen. Methods A prospective case-control study were performed in 66 patients with traumatic spleen rupture including the retroperitoneal splenic autotransplantation in 32 and the omentum of splenic autotransplantation 34 cases. The blood routine, blood IgA, IgM, IgG, C3 and Tuftsin level were measured after 1 day and 12 of surgical performance Results The operation time in retroperitoneal splenic autotransplantation group was shorter than that in omentum of splenic autotransplantation group （P〈0.05）. In the omentum of splenic transplantation group, postoperative adhesive obstruction was 1 case. Serum IgA, IgM, IgG, C3, Tuftsin levels showed no significant differences in two groups. Conclusion The treatment of retroperitoneal splenic autotransplantation can retain part of spleen function, and the operation is relatively simple.