儿童保留脾脏手术34例

Spleen preserving procedure in children

目的 探讨儿童全部或部分保留脾脏的手术方式。方法 回顾 1982～ 1998年 32例外伤性脾破裂与 2例良性脾脏肿瘤施行全部或部分保留脾脏 4种手术方法。结果 术后 4周血清免疫测定值处于同地区同年龄组正常值低水平范围内 ,其中 3例术后第 3周内发生OPSI,另 1例全脾切除后 5年发生粘连性肠梗阻并发肠源性感染性休克 ,占同期脾切除患儿 5 % (4/ 80 )。34例行各种保留脾脏手术的患儿 ,包括 4例OPSI患儿全部治愈出院 ,并获得 90 .6 %长期随访 ,均健在。结论 全部或部分保留脾脏手术应予以提倡 ,并进一步探索新方法。

Objective The feasibility of spleen preserving procedures in children with traumatic spleen rupture was evaluated.Methods Thirty-two children with traumatic spleen rupture and 2 children with benign splenic tumor were reviewed. Spenorrhaphy, subtotal splenectomy, partial and total spleen auto-transplantation were carried out. Results Post-operatively, three patients developed overwhelming post-splenectomy infection (OPSI) on the 3rd week. One child developed intestinal obstruction and septic shock 5 years post-operatively. All patients, including the children with OPSI, recovered and were discharged. Thirty ( 90.6% ) patients were followed-up for 6.5 years (0.5 to 13 years).Conclusion The authors advocate spleen preserving procedures in spleen rupture in children.