摘要
目的总结外伤性脾破裂诊疗经验。方法对1986～2006年收治的112例外伤性脾破裂临床资料进行回顾性分析。结果本组非手术治疗15例,手术治疗96例,手术并发症8例,其中再出血2例,均再次剖腹手术,缝扎止血;胰漏2例,予以充分引流,使用广谱抗生素、生长抑素及肠外营养支持治疗,2～3周后胰漏闭合;继发腹腔感染4例,经腹腔引流、抗感染、支持疗法后治愈;死亡2例,其中术前死亡1例,系血气胸并严重脾破裂的复合伤,入院时血压为0,抢救3h内死亡,1例术后第8天死于大面积心肌梗死。结论脾外伤的治疗应根据患者个体及脾破裂类型而定,尽量采取多种方式保脾。
Objective To sum up the experience for the treatment of splenic trauma. Methods Data of 112 cases with traumatic splenic rupture from 1986 to 2006 were retrospectively analyzed. Results Conservative management was undertaken in 15 cases,there were 96 patients who received operations and 8 of the 96 patients, developed complications after operations including 2 patients suffered from bleeding and both of them got coeliotomies in order to stop bleeding by means of sewing,in addition, 2 of the 96 patients got pancreas fistula who were treated with drainage of wide antibiotics somatostatin and nutrition supplies and theirs wands turned out to be hesled after 2 or 3 weeks. As for the celiac infections,there were 4 of the whole who were taken measures in the way of celiac drainage,resistance of infection and supportive care were cured at last,unfortunately 2 patients died, one died of pneumohemothorax along with combined injury of spleen before operation within 3 hours,whose blood pressure showed zero at the time of arriving at hospital. The other died of myocardial infarction on large scale 8 days after operation. Conclusion In splenic trauma, treatment morality should be on adopted case to case basis according to the types of splenic rupture,combined splenic salvage can be used on certain conditions.
出处
《中国现代医生》
2008年第12期23-24,共2页
China Modern Doctor
关键词
脾外伤
诊断
手术
治疗
Splenic rupture
Therapy
Operative
Treatment
