脾切除术中医源性损伤的原因分析

Iatrogenic Injury during Splenectomy-a report of 18 cases

目的 分析脾切除术中周围脏器损伤的原因。方法 回顾分析 1 8例脾切除术中周围脏器损伤的病例。结果 胰腺损伤 5例 ,胃损伤 4例 ,肝脏损伤 2例 ,结肠损伤 5例 ,膈肌损伤 1例 ,左肾损伤 1例。结论 发现脾切除术中周围脏器损伤的发生与脾脏的病理性改变如巨大脾、周围紧密粘连以及术者操作不够规范。

Objective To analyze the causes of peripheral viscera injury during splenectomy. Methods The data of 18 patients in our hospital from 1980～2000 were retrospectively analyzed. Results Pancreatic injury in 5 cases, gastric injury in 4 cases, hepatic injury in 2 cases, colon injury in 5 cases, diaphragmatic injury in 1 case and left renal injury in 1 case were detected. Conclusion The causes of iatrogenic injury during splenectomy were closely related to various factors such as serious spleen pathological changes, the changes of anatomy relation owing to huge spleen and tight adhesions in part and the operations lack of standard and carefulness.