脾破裂原位保脾手术52例临床疗效分析

CLINICAL EFFECT ANALYSIS OF 52 CASES OF SPLEEN-SAVING OPERATIONS IN THE TREATMENT OF SPLEEN RUPTURE

目的 :探讨原位保脾手术的方法及适应症。方法 :根据脾脏的解剖学特点及脾脏损伤的分级 ,分别采用脾脏缝合修补术、胶粘术及脾部分切除术 ,必要时联合应用 2～ 3种手术方法。结果 :5 2例中 ,行脾规则或不规则叶、段及脾大部切除 42例 ,15例联合应用 2～ 3种保脾术式。全组无死亡 ,无术后大出血等并发症 ,经 6个月～ 9年的随访 ,随脏质地正常 ,对感染的易感性无明显增加 ,未见OPSI的发生。结论 :临床综合应用原位保脾技术安全而有效。

Objective:To study the operational method of retaining spleen at its original place and the conditions to apply the operation.Methods:Spleen suture operation,adhering operation,and spleen partial resection have been used according to the spleen anatomical features and the degrees of spleen injury.Results:Of the 52 cases,42 cases have undergone regular or irregular spleen lobe,section,or greater part removal,15 cases have undergone 2 to 3.different methods of spleen-saving operation.No death,massive hemorrhage and other complications occurs.In the half year to nine years follow-up investigations,the spleen texture of the patients are normal and the possibiliy of the patients' catching infection doesn't increase much.NO OPSI is found.Conclusions:It's safe and effective to use the comprehensive spleen-saving operational method in clinical practice.