脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察

Clinical therapeutic effect of splenic arterial embolization on rupture of spleen in 28 cases

目的探讨脾动脉栓塞术对外伤性脾破裂的疗效及并发症的处理。方法采用 Seldinger法行脾动脉栓塞术治疗外伤性脾破裂 2 8例。结果所有患者出血立即停止 ,其中 4例行 2次栓塞。 2 8例均有脾区疼痛 ,2 2例发热。脾动脉栓塞 5天后血小板、白细胞上升近 1倍 ,7天后恢复至正常范围。2 8例随访 6～ 3 6月 ,查免疫球蛋白、CT等结果满意 ,未有再出血及发生暴发性感染。结论脾动脉栓塞不但有良好的止血作用 ,而且能保留脾脏的免疫功能 ,可在非手术治疗失败时选用 。

Objective To explore the therapeutic effect of splenic arterial embolization (SAE) for treating rupture of spleen and management of complications. Methods 28 cases of rupture of spleen underwent SAE by means of Seldinger. Results Bleeding in all the patients stopped immediately. Of 28 cases,4 underwent 2 embolizations. 28 cases felt painful in the spleen area and 22 felt fever.5 days after splenic arterial embolization,blood platelets and WBC increased nearly twice as much as before,which became normal 7 days later.28 cases were followed up for 6～36 months with satisfying results of the detection of immunoglobulin and CT. No bleeding and overwhelming postsplenectomy infection occurred. Conclusion SAE is an effective way of treating rupture of spleen,which can be applied when non operational treatment is not successful,because SAE not only can prevent bleeding but also can keep the immunological function of spleen.