部分脾栓塞术治疗外伤性脾破裂的临床应用

Clinical application of artial splenic embolization for the treatment of traumatic spleen rupture

目的 探讨部分脾栓塞术（partial splenic embolization,PSE）治疗外伤性脾破裂的治疗效果.方法 回顾性分析2013年1月至2015年1月28例行开腹脾切除术治疗外伤性脾破裂病人的临床资料及同期开展的27例行PSE治疗外伤性脾破裂病人的临床资料并行对比分析.结果 行开腹脾切除术治疗组28例均痊愈.行PSE治疗组27例中,26例顺利完成选择性出血血管栓塞,其中1次栓塞成功25例,再次栓塞成功1例,无继发出血及开腹手术病例;1例栓塞过程中发现脾动脉主干受损,行脾动脉主干栓塞控制出血后立即中转开腹行手术处理;均痊愈出院.结论 PSE是治疗外伤性脾破裂的一种有效、微创的方法,且保留了脾脏功能.

Objective To explore the curative effect of partial splenic embolization （PSE） for traumatic spleen rupture. Methods The clinical data of 28 cases of traumatic spleen rupture subject to splenectomy and 27 cases of traumatic spleen reupture to splenic artery PSE at the same period from Jan. 2013 to Jan. 2015 in our hospital were retrospectively analyzed and compared. Results In sple- nectomy group, 28 patients were recovered. In PSE group, selective bleeding vascular embolization was successfully performed on 26 cases （one time for 25 cases, and two times for 1 case）. There were no secondary bleeding and laparotomy. In the rest one case, splenic artery was damaged during the embolization, and then laparotomy splenectomy was imnlediately given to control bleeding. All pa- tients were recovered. Conclusions PSE is one of the effective and minimally invasive treatments for traumatic spleen rupture, and preserves the function of the spleen.