小儿外伤性脾破裂治疗43例分析

Analysis of the Treatment for Splenic Trauma in 43 Children-

目的 探讨儿童脾外伤保脾治疗的可行性和安全性。方法 自 1990 - 0 1～ 2 0 0 2 - 0 2共收治小儿钝性脾外伤4 3例 ,男 30例 ,女 13例 ,年龄 5～ 12岁。按 Feliciano脾外伤分级 : 级 5例 , 级 12例 , 级 14例 , 级 6例 , 级 3例 ,复合伤 13例 ,合并失血性休克 5例。手术治疗 33例 ,非手术治疗 10例。手术组中全脾切除 2 8例 ,部分脾切除 3例 ,ZT胶修补 2例 ,非手术组中 1例治疗失败中转手术。结果 全组痊愈 ,无死亡及与脾损伤相关的并发症。结论 儿童钝性脾外伤的保脾治疗是安全可行的。儿童脾外伤的治疗应根据临床表现尽可能地保留脾脏功能。

Objective To investigate safe and practical therapy for blunt splenic trauma in children.Methods Fourty three cases,aged from 5～12ys,were admited to our hospital from Januaty 1990 to February 2002.Among these cases,there were 5 cases with Feliciano Ⅰ,12 withⅡ,14 with Ⅲ,6 with Ⅳ and 3 with Ⅴ ,including 13 cases with combinative trauma and 5 with shock.Results Splenectomy was used on 28 children,partial splenectomy on 3, repairment with biogel on 2 and 10 received non operative treatment. One child in the non operative treatment group failed and was performed operation.There was no death and complications resulted from splenic trauma.Conclusions Therapy of the splenic preservation was safe and practical for splenic blunt trauma in children.The choice of the therapy should be based mainly on clinical manifestation,ultrasonography and CT.