王展福

[摘要] 目的 探讨选择性行脾破裂保脾手术治疗外伤性脾破裂的临床疗效和安全性。 方法 回顾性分析我院采用保脾手术治疗的40例外伤性脾破裂患者的临床资料，并以既往采用脾切除治疗的40例患者为对照组，比较两组患者的临床疗效与并发症情况。 结果 ① 观察组治愈率为95.0%，对照组治愈率为92.5%，组间比较无统计学意义（P>0.05）；② 观察组住院时间（13.6±4.7）d、并发症发生率（7.5%）均小于对照组（21.4±6.9）d和25.0%。 结论 采用选择性脾破裂保脾手术治疗外伤性脾破裂可有效确保患者安全，缩短住院时间，值得临床推广。

[关键词] 脾破裂；保脾治疗；脾切除

[中图分类号] R657.6 [文献标识码] B[文章编号] 1673-9701（2012）02-0151-02

Observation on effectiveness of selective spleen retaining surgery on traumatic spleen rupture

WANG Zhanfu

NO.2 Surgical Department of TCM Hospital in Guangxi Zhuang Autonomous Region, Wuzhou 543002, China

[Abstract] Objective To explore the effectiveness and safety of selective spleen retaining surgery on traumatic spleen rupture. Methods Retrospective study was conducted on medical documents of 40 cases undergoing spleen retaining surgery (observational group), and comparative study was introduced on another 40 cases experiencing splenectomy(comparative group), based on which,clinical effect and complications were compared. Results ① Cure rate (95.0%) inobserva tional group is higher than comparative group (92.5%), but there is no difference between two groups. ②Hospital stay after surgical operation and incidence rate of complications of observational group [(13.6±4.7)d, 7.5%]were less than comparative group[(21.4±6.9)d, 25.0%]. ConclusionCompared with splenectomy ,Selective spleen retaining surgery can effectively guarantee patients safety, cut hospital stay, and be worthy of popularization.

[Key words] Spleen rupture；Spleen retaining surgery；Splenectomy

脾脏是人体重要的免疫器官，血运丰富，质地较脆，在外力冲击下极易发生破裂。外伤性脾破裂约占腹部外伤的20%~40%[1]。以往临床多采用脾脏切除术治疗脾破裂，近年来，临床多主张在有条件的情况下采用保脾手术治疗，以保证免疫系统的完整性，降低并发症发生率[2]。我院采用保脾手术治疗40例脾破裂患者，取得满意效果，报道如下。

1 资料与方法

1.1一般资料

观察组40例患者来自我院2006年7月~2011年7月因外伤行保脾手术治疗的脾破裂患者，其中男27例，女13例；年龄8~48岁，平均（31.7±5.6）岁；受伤到就诊时间隔30 min~2 d；对照组40例患者为既往在我院行脾切除治疗的外伤性脾破裂患者，男28例，女12例；年龄9～48岁，平均（32.5±6.2）岁；受伤到就诊时间隔30 min～2 d。两组患者的性别、年龄、急诊间隔均不存在明显差别。

1.2 方法

对照组患者在硬膜外麻醉或全麻下行脾切除术治疗。观……