外伤性脾破裂的保脾治疗

Preserving spleen treatments to traumatic rupture of the spleen

目的 探讨外伤性脾破裂时各种保脾疗法的临床应用。方法 回顾性总结我科自 2 0 0 0年 1月 1日～ 2 0 0 1年 12月 31日 10 9例外伤性脾破裂的临床资料。结果 全组非手术保脾疗法 36例 ,部分脾动脉栓塞 (PSE)介入保脾术 38例 ,脾网片捆扎保脾术 17例 ,全组保脾成功率占同期 82 5 %(91/ 10 9) ,无一例死亡。各种保脾疗法后行Bus、CT及99mTC检查 ,测定血小板、IgM、IgG、C3 、C4 免疫指标 ,随诊半个月～ 10个月 ,脾脏均正常存活 ,免疫功能正常。结论 根据具体情况选用非手术保脾疗法、部分脾动脉栓塞 (PSE)介入保脾术、脾网片捆扎保脾术 ,均为疗效确切、安全可行的保脾方法 ,符合现代脾脏外科保脾及其功能的基本要求。

AIM Exploring the clinical application of a variety of preserving spleen treatments to traumatic rupture of the spleen. METHODS Reviewing the clinical data of traumatic rupture of the spleen in 109 cases between 1th, Jan 2000 and 31th Dec 2001. RESULTS The series of treatments to preserving spleen were 36 cases of nonoperative management, 38 cases of partical splenic artery embolism and 17 cases of wrapping the spleen with polyglactin mesh. The successful rate was 82.5%(91/109) all of the cases , none died. Following the last half month to one year, the immunologic funcation was normal by determining platelet IgM, IgG, C 3 and C 4 , the spleen survived by detecting Bus, CT and 99mTC. CONCLUSION The three techniques are safe and effective to preserving spleen, conforming modern splenic surgery demands.