外伤性脾破裂非手术治疗29例体会

Eperience of nonoperative management for 29 cases of traumatic spleen rupture

目的 总结外伤性脾破裂的非手术治疗经验。方法 对我院 1993～ 2 0 0 2年以禁食、卧床、止血、抗生素等非手术治疗2 9例外伤性脾破裂的临床资料进行分析。结果 2 9例均非手术治愈出院 ,住院时间 8～ 2 2 d,平均 15 d;获随访 2 5例 ,随访 3～6个月 ,无 1例出现并发症。结论 只要严格掌握适应证和密切动态观察病情变化 ,随时做好中转手术的准备 ,非手术治疗外伤性脾破裂是安全可行的 ,是一种重要保脾手段 ,对非手术治疗期间血液动力学不稳定或发生延迟性出血者应及时手术。

Objective To give a summary of experience in non-operative methods treating traumatic rupture of spleen.Methods Clinical information of 29 cases suffering traumatic rupture of spleen were analysed and treated with non-operative tratment such as fasting,laying up,hemostasia and using antibiotic during 1993-Dec,2002.Results All of the 29 cases were fully recovered and discharged,length of stay was 8～22d,with average of 15d,25 of them were followed up with 3～6 months and there was no complications found.Conclusions None-iperative treatment can be safely applied in treating traumatic rupture of spleen on conditions that the indication is well chosen and all the changes of the patients are well observed,as well as all the necessary preparation for converting to open operation are made,this treatment is an important way to preserve the spleen.However,operation should be done in time when blood kinetics is instable or there is delayed hemorrhage during the non-operation therapy.