创伤性脾破裂保留脾脏治疗57例分析

Analysis on the treatment of spleen-preserving surgery in 57 cases with traumatic spleen rupture

目的探讨创伤性脾破裂保脾方法和疗效。方法分析2001年1月至2011年1月采取保脾治疗57例创伤性脾破裂:非手术治疗6例,单纯缝合修补7例,用结缔组织片缝合修补13例,脾部分切除3例,脾脏切除合并自体脾脏片大网膜移植28例。结果治愈56例,1例死于合并腹膜后血肿及慢性肝病,其中4例并发脾切除热,平均住院时间11.7d。结论根据脾损伤的程度和患者全身情况,选择适宜的保留脾脏治疗方法既保留脾脏功能,又能安全有效地抢救生命,减少并发症,降低病死率。

Objective To explore the methods and curative effect of spleen-preserving surgery in the treatment of traumatic rupture of the spleen.Methods Traumatic rupture of the spleen in 57 cases of the treatment of spleen-preserving surgery from January 2001 to January 2011 were analyzed.Among the 57 cases,6 cases were treated non-operatively.7 cases were sutured and restored simply.13 cases were sutured and restored with connectivum lamella.3 cases were conducted splenectomy partly.28 cases were conducted splenectomy and transplantation of greater omentum and the spleen of itself.Results Among the 57 cases,56 cases cured after spleen-preserving treatment,1 case died of the complication of retroperitoneal hematoma and chronicity hepatopathy.4 patiens of splenectomy was observed fever.The average time of hospitalization was 11.7 days.Conclusion We select suitable modus operandi of spleen-preserving,which based on injure of spleen′s degree and condition of patients,the effects that keep the function of spleen,and rescue life safe and utility,and reduce complication,and depress case fatality rate.