摘要
目的 探讨脾创伤保脾术的术式选择。方法 对脾创伤采用术中保脾的 15 8例手术方式进行分析 ,其中氩气刀止血 5例 ,ZT生物胶止血 3例 ,单纯脾修补术 2 6例 ,脾部分切除术 77例 ,修补加脾部分切除术 12例 ,脾切除自体脾组织片网膜囊内移植术 35例。结果 全组病例治愈出院。脾切除自体脾组织片网膜囊内移植术组 35例中 ,2例出现粘连性肠梗阻 ,11例出现各类术后感染 ,而其它术中保脾组 12 3例中 ,10例出现术后感染 ,两组总感染数比较 ,P <0 .0 1。结论 脾创伤术中保脾术的术式选择 ,应根据病人个体情况及脾破裂的类型而定 ,必要时采用联合多种术式保脾。对伴有空腔脏器破裂者也可选择性保脾。但应慎重选择脾切除自体脾组织片网膜囊内移植术。
Objective To evaluate the choice of splenic salvage operations in splenic trauma.Methods Several splenic salvage operations were performed on 158 cases of splenic trauma from Oct.1987 to Oct.1999.Among them 5 cases were treated by argon beam coagulator, 3 ZT biotic binding agent, 26 splenorrhaphy, 77 partial splenectomy, 12 combined splenorrhaphy and partial splenectomy, 35 total splenectomy with autologous spleen slices implanted into the greater omentum.Results All the patients were cured.In the group of total splenectomy with autologous spleen slices implanted into the greater omentum (35 cases), 2 suffered from adhesive intestinal obstruction and 11 from postoperative infection, while in the group of other splenic salvage operations (123 cases), 10 suffered from postoperative infection.The infection rate in these two groups was statistically different ( P < 0.01 ).Conclusion In splenic trauma, choosing a splenic salvage operation should be in accordance with patient's individual situation and types of splenic rupture.Combined splenic salvage operations can be applied in certain conditions.For those patients together with rupture of hollow viscus, splenic salvage operations also can be done selectively.The total splenectomy with autologous spleen slices implanted into the greater omentum should be carefully selected.
出处
《腹部外科》
2001年第4期217-218,共2页
Journal of Abdominal Surgery
