摘要
目的探讨脾切除术后联合大网膜自体脾片种植治疗外伤性脾破裂的临床效果。方法选择2010年1月~2019年4月本院收治的外伤性脾破裂患者50例,按照实施手术方法不同,分为两组(观察组与对照组),各25例。所有患者均在全身麻醉气管插管下实施手术,其中对照组实施单纯的开腹脾切除术,观察组在实施常规脾切除术后,进行大网膜自体脾片种植术,比较两组术后2周机体体液免疫功能情况,统计两组术后2周术后感染发生率及临床救治成功率,计算观察组种植物成活率。结果术后2周,观察组体液免疫指标中IgG、IgA、sIgA、IgM水平均明显高于对照组(P<0.05),观察组术后2周内术后感染发生率显著低于对照组(P<0.05),整体临床救治成功率高于对照组(P<0.05),经术后腹部超声检查,观察种植物成活率达96.0%。结论脾切除术后行大网膜自体脾片种植术,能有效确保术后外伤性脾破裂患者免疫功能,提高临床救治成功率,且种植成功率较高。
Objective To investigate the clinical effect of splenectomy combined with greater omentum implantation of autologous splenic segments in treatment of traumatic rupture of spleen. Methods A total of 50 patients with traumatic spleen rupture admitted to our hospital from January 2010 to April 2019 were enrolled and divided into two groups(observation group and control group) according to different surgical methods, with 25 patients in each group. The surgery was performed under general anesthesia and tracheal intubation for all the patients. The control group was given the simple open spleen resection and the observation group was given the greater omentum implantation of autologous splenic segments after conventional splenectomy. The body humoral immune function between the two groups 2 weeks after surgery were compared. The incidences of postoperative infection and the success rates of clinical treatment between the two groups 2 weeks after surgery were calculated. The implant survival rate of the observation group was calculated. Results Two weeks after surgery, the levels of humoral immune indices, namely IgG, IgA, sIgA and IgM, in the observation group were significantly higher than those in the control group(P<0.05). In two weeks after surgery, the incidence of postoperative infection in the observation group was sig nificantly lower than that in the control group(P <0.05), and the implant survival rate in the observation group was significantly higher than that in the control group(P<0.05). It was found by postoperative abdominal ultrasound that the im plant survival rate in the observation group was 96.0%. Conclusion For the patients having received splenectomy, the implementation of greater omentum implantation of autologous splenic segments can effectively ensure the immune function of patients after surgery and improve the success rate of clinical treatment, and the implantation success rate is high.
作者
甘家兵
GAN Jiabing(Department of General Surgery,Jingdezhen Second People's Hospital in Jiangxi Province,Jingdezhen333000,China)
出处
《中国现代医生》
2019年第32期45-47,共3页
China Modern Doctor
关键词
脾切除
大网膜自体脾片种植
体液免疫
救治成功率
种植成功率
Splenectomy
Greater omentum implantation of autologous splenic segments
Humoral immunity
Success rate of treatment
Implantation success rate
