外伤性脾破裂脾部分切除术的临床研究

Clinical Study of Partial Splenectomy in Pations Undergoing Traumatic Spleen Rupture

目的 总结外伤性脾破裂脾部分切除术的临床经验。方法 外伤性脾破裂行部分切除术 5 9例为保脾组 ,与同期外伤性脾切除术 60例、胃肠手术组 60例比较。分别于术前、术后 1月、1年检测免疫功能、红细胞滤过功能。结果 保脾组与胃肠组无统计学差异 ,保脾组IgM、NK细胞活性、T淋巴细胞亚群、T淋巴细胞转化率均明显高于切脾组 (P <0 0 1) ;外周血痘痕红细胞明显低于切脾组 (P <0 0 1) ;99mTc、B超、CT检查示脾脏的结构及吞噬功能正常。结论 外伤性脾破裂行部分切除术能保存脾脏的生理功能。

Objective To summarize the experience of partial splenctomy in patients with traumatic spleen rupture.Methods Patients were assigned to spleen conservation group in which 59 patients underwent partial splenectomy,control group Ⅰ in which 60 patients underwent splenectomy and control group Ⅱ in which 60 patients underwent gastroinestinal operation. Immunologic function and filtration of red blood cell were detected in the three groups during the preoperation and the first month,the first year postoperation respectively.Results There was no significant difference between the spleen conservation group and the gastroenteric operation group.But IgM,NK-cell activity,T lymphocyte subpopulation and T lymphocyte transformation rate in the spleen conservation group were significantly higher then those in the splenectomy group (P<0 01).Pockmark red blood cells in peripheral circulation were significantly lower then those in the splenectomy group (P<0 01). 99m Tc B-us CT suggested that the spleen constitutional function was recovered well in the spleen conservation group.Conclusion Partial splenctomy can rather conserve the physiological functhion of spleen.