外伤性脾破裂术式探讨(附61例报告)

Operative Options in Traumatic Rupture of the Spleen(A Report of 61 Cases)

目的 :探讨外伤性脾破裂的手术方式。方法 :对 6 1例外伤性脾破裂作回顾性分析 ,包括复合性外伤 31例 (其中合并休克 17例 ) ,单纯性脾破裂 2 1例 (其中合并休克 9例 ) ,迟发性脾破裂 6例 ,脾包膜下破裂 3例。结果 :5 4例行全脾切除术 ,1例保留附脾 (2 0岁 )。 7例非手术治疗。治愈 5 7例 (93.5 % ) ,死亡 4例 (6 .5 % )。结论 :虽然脾脏具有重要免疫功能 ,是人体最大的淋巴器 ,有抗感染、抗肿瘤作用。但手术原则仍应遵循抢救生命第一 ,保脾第二。

Objective: To discuss the operative options in traumatic rupture of the spleen. Methods: 61 cases of traumatic rupture of the spleen were retrospectively reviewed and analyzed. These included 31 cases of multiple trauma with 17 in shock, 21 simple rupture with 9 in shock, 6 delayed rupture and 3 subcapsular rupture. Results: 54 cases were to subjected to splenectomy. An accessory spleen was preserved in a 20 years old patient. 7 cases were treated nonoperatively. Altogether 57 cases(93.5%) were cured. There were 4 deaths (6.5%). Conclusion: Spleen is the body's largest lymphoid organ with important immunologic functions. The guiding principle in the treatment of splenic rupture should be 'life comes first' and 'spleen preservation comes second'.