射频辅助保脾手术治疗小儿外伤性脾破裂

Radiofrequency ablation assisted spleen-preserving surgery for traumatic splenic rupture in children

目的探讨射频辅助保脾手术在小儿外伤性脾破裂保脾手术的可行性。方法2010年1月至2013年3月对16例患儿实施射频消融辅助保脾手术。男11例，女5例，年龄4～16岁，平均（9．15±3．2）岁。常规开腹探查腹腔后使用凝血器手术电极对脾脏裂口进行射频止血或脾部分切除。结果15例均顺利完成保脾手术，1例改为脾切除。手术时间50~90min，出血量20～150ml，术后无消化道漏，无出血，术后7d出院，随访2周至2年，CT提示无脾脓肿，脾周无明显积液；血小板在正常范围。结论射频消融技术在小儿外伤性脾破裂保脾手术中具有可行性。

Objective To explore the clinical feasibility of the radiofrequency ablation （RFa） assisted spleen-preserving surgery in children for traumatic splenic rupture. Methods From Jan 2010 to Mar 2013, 16 cases with traumatic splenic rupture were treated by the radiofrequency ablation （RFa） assisted spleen-preserving surgery. There were 11 boys and 5 girls, aged from 4-16 years （9. 15 -＋ 3. 2 years）. Conventional exploration, then a radiofrequency electrode to stop the bleeding of ruptured spleen or partial splenectomy was used for these patients. All of them were followed up. Results Spleen-preserving surgery was successfully performed on 15 cases and splenectomy performed on 1 case. Operation time ranged from 50 to 90 rain, the blood loss was 20 ml to 150 ml. No complications of gastrointestinal tract leakage or bleeding occurred. All patients were discharged 7 days after surgery. From 2 weeks to 2 years follow-up, no splenic abscess, subcasular or perisplenic fluid or hematomas was detected by CT examination. Platelets remained normal. Conclusions Radiofrequency ablation （RFa）assisted spleen-preserving surgery is clinically feasible for the treatment of traumatic splenic rupture in children.