摘要
目的:探讨选择性脾部分栓塞术在治疗I-II级外伤性脾破裂中的应用价值。方法:选取江油市九O三医院收治的100例Ⅰ~Ⅱ级外伤性脾破裂患者作为研究对象,根据手术方法分为A组61例(脾切除术组)、B组39例(介入组),对比两种方法的手术时间、输血量、住院时间、手术成功率及手术前后患者免疫状况的变化。结果:A组患者的手术时间、输血量、住院时间显著高于B组(P<0.05);A组的手术成功率(90.16%)与B组的(94.87%)比较差异无统计学意义(P>0.05);术后14 d及28 d,A组的CD3+、CD4+、CD4+/CD8+水平显著低于B组(P<0.05),A组的CD8+显著高于B组(P<0.05);术后14 d及28d,A组的Ig A、Ig G、Ig M水平显著低于B组(P<0.05);A组患者的手术并发症率与B组比较差异无统计学意义(P>0.05)。结论:选择性脾部分栓塞术对Ⅰ~Ⅱ级外伤性脾破裂患者的手术效果与脾切除术效果相当,但创伤较小、术后患者免疫功能恢复较快。
ObJective： To evaluate the value of selective splenic embolization in the treatment of Ⅰ-Ⅱ traumatic rupture of the spleen. Methods： A total of 100 patients with Ⅰ-Ⅱtraumatic rupture of the spleen ruptured at Nine 03 Hospital of Jiangyou were enrolled in this study. They were divided into two groups according to the surgical methods： 61 cases in group A （splenectomy group）, 39 cases in group B（intervention group） .Compare the two methods of operation time, blood transfu- sion, hospital stay, the success rate of surgery and changes in patients with immune status before and after surgery. Results： The operation time, blood transfusion and hospital stay in group A were significantly higher than those in group B （P〈0.05）. The success rate of operation in group A was 90.16% and 94.87% in group B, respectively, with no significant difference between the two groups（P〉0.05）; The levels of CD3＋, CD4＋ and CD4＋/CD8＋ in group A were significantly lower than those in group B on day 14 and day 28（P〈0.05）, and were significantly higher in group A than those in group B（P〈0.05）. The levels of IgA, IgG and IgM in group A were significantly lower than those in group B at 14 and 28 days after operation （P〈0.05）. The operative complication rate in group A was 11.48%, which was not significantly different from that of group B （P〉0.05）. Conclusion： Selective partial splenic embolization has similar efficacy to splenectomy in patients with grade Ⅰ-Ⅱ traumatic splenic rupture, but less trauma and faster recovery of immune function after surgery.
作者
柏宇
Bo Yu(Department of Second Surgery, Jiangyou 903 Hospital（Jiangyou 621700, China）)
出处
《中国现代普通外科进展》
CAS
2018年第8期616-618,622,共4页
Chinese Journal of Current Advances in General Surgery
关键词
脾切除
部分脾动脉栓塞
外伤性脾破裂
Partial splenectomy
Partial splenic embolization
Splenic traumatic rupture
