外伤性脾破裂70例临床分析

Clinical analysis of 70 patients with traumatic rupture

目的总结分析外伤性脾破裂的临床治疗措施。方法选择2010年6月至2012年11月收治的70例外伤性脾破裂患者为研究对象，回顾分析其临床诊疗资料，总结手术治疗及非手术治疗的效果。结果40例全脾切除术患者术后发生手术区积液8例、切口感染3例，经抗感染治疗后均痊愈；22例部分脾切除术患者术后发生手术区积液2例、切口感染2例，对症治疗后痊愈；8例均经非手术治疗后康复。术后所有患者随访半年，40例全脾切除术患者中20例感觉体力下降，22例部分脾切除患者中10例感觉体力下降，均伴有间歇性左上腹隐痛。8例非手术治疗患者随访期间未出现体力下降情况，均恢复到伤前状态。结论对于外伤性脾破裂患者来说及时诊断是救治前提，首选手术治疗术式为脾切除术，如何选择安全、有效的适合患者的治疗方法是提高预后的关键所在。

Objective To investigate the clinical treatment methods for patients with traumatic rupture. Methods Seventy patients with traumatic rupture in the People＇ s Hospital of Huojia, from June 2010 to November 2012, were selected as study group. The clinical diagnosis and treatment information were summarized and effects of surgery and non- surgical treatment were analyzed. Results Among the 40 patients after splenectomy, 8 cases with whole surgical area effusion, 3 cases of wound infection, 40 patients were cured after anti-infective therapy. Twenty-two patients after part sple- nectomy, 2 cases with whole surgical area effusion, 2 cases of wound infection, they were cured after anti-infective therapy. Eight cases were back to health after non-surgical treatment. All patients were followed up for 6 months, among the 40 ca- ses of fu11-splenectomy patients, 20 cases felt physical decline. Among the 22 cases of part splenectomy, 10 cases felt physical decline, with intermittent dull pain in the left upper quadrant. Eght cases with non-surgical treatment without physical decline and were restored to pre-injury status. Conclusions For patients with traumatic rupture of timely diagnosis is the prerequisite for treatment, surgical treatment of choice for surgical splenectomy, how to choose a safe and effective method for the treatment of patients is the key to improving prognosis.