脾动脉栓塞术在创伤性脾破裂患者中的应用效果

Application effect of splenic artery embolization in patients with traumatic splenic rupture

目的探讨脾动脉栓塞术在创伤性脾破裂患者中的应用效果。方法选取2020年5月至2021年4月合肥市滨湖医院收治的40例创伤性脾破裂患者作为研究对象,依照随机数字表法分为手术组(20例)和介入组(20例)。手术组患者采用外科手术,介入组患者行脾动脉介入栓塞术治疗,比较两组患者的手术指标、手术前后细胞免疫水平和并发症总发生率。结果介入组患者的手术时间、下床时间和住院时间均短于手术组,术中出血量少于手术组,差异有统计学意义(P<0.05);两组患者术前的CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)指标水平比较,差异无统计学意义(P>0.05);术后1周,介入组患者的CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均高于手术组,差异有统计学意义(P<0.05)。介入组的手术并发症总发生率为5.00%,低于手术组的35.00%,差异有统计学意义(P<0.05)。结论在创伤性脾破裂中行脾动脉栓塞术治疗能够有效止血,保留脾脏及其功能,相比外科手术治疗,手术时间更短,创伤更小,能够促进患者免疫功能恢复,有效降低相关并发症发生率,安全性较高,有助于缩短住院时间,临床应用推广价值较高。

Objective To explore the application effect of splenic artery embolization in patients with traumatic splenic rupture.Methods A total of 40 patients with traumatic splenic rupture admitted to Binhu Hospital of Hefei City from May 2020 to April 2021 were selected as the research objects.According to the random number table method,they were divided into the surgical group(20 cases)and the interventional group(20 cases).The surgical group was treated with surgery,the interventional group was treated with splenic artery embolization.The operative indexes,cellular immunity level before and after surgery and the incidence rate of total complication were compared between the two groups.Results The operation time,time to get out of bed and length of hospital stay in the interventional group were shorter than those in the surgical group,the intraoperative blood loss in the interventional group was less than that in the surgical group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) between the two groups before surgery(P>0.05).The levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+) in the intervention group at 1 week after surgery were higher than those in the surgery group,with statistically significant differences(P<0.05).The total incidence of complications in the interventional group was 5.00%,which was lower than 35.00%in the surgical group,and the difference was statistically significant(P<0.05).Conclusion Splenic artery embolization in the treatment of traumatic splenic rupture can effectively stop bleeding,preserve spleen and its function,compared with surgical treatment,the operative time is shorter and the trauma is less,it can promote the recovery of immune function of patients,effectively reduce the incidence of related complications,safety is higher,which can help to shorten the hospitalization time,and there is higher value of clinical application and popularization.