西北国防医学杂志2017，Vol.38Issue(11)：719-722,4.DOI:10.16021/j.cnki.1007-8622.2017.11.006
腹腔镜脾切除术联合术中自体输血治疗外伤性脾破裂的疗效研究
Effect of laparoscopic splenectomy combined with intraoperative autotransfusion for traumatic splenic rupture
范瑞芳 1肖毅 1许树林 1党政 1上官建营 1张超 1吕志诚 1牛刚 1李月胜1
作者信息
- 1. 解放军兰州总医院肝胆外科,甘肃兰州 730050
- 折叠
摘要
Abstract
Objective:To study the feasibility and safety of laparoscopic splenectomy (LS) combined with intraoperative autotransfusion (IAT) for the treatment of traumatic splenic rupture.Methods:Thirty-one patients with traumatic splenic rupture undergoing LS and IAT were admitted from February 2012 to October 2016.The clinical index were observed and analyzed,including the time of splenic artery block,total operation time,autologous blood transfusion volume,postoperative abdominal drainage volume,length of hospital stay and complications.Results:All the patients were diagnosed as traumatic splenic rupture.The splenic injuries were classified as grade Ⅱ in 5,grade Ⅲ in 20,and grade Ⅳ in 6 patients.And pancreatictail injury in 2,left kidney injury in 4,1eft multi fractures ribs in 9,and hemothorax or hemopneumothorax in 4.The preoperative hemodynamics stability in 12 patients,and the other 19 patients were stable after preoperative antishock therapy.The LS and IAT were successfully implementated in 31 patients,without conversion to laparotomy.Two patients were given pancreatic tail repair,2 patients were given left thoracic close drainage,and 1 patient was given thoracentesis.The mean time of splenic artery block was (18.5±3.5) minutes,the mean total operation time was (125 ± 36) minutes,the mean autologous blood transfusion volume was (1 456 ± 305) ml,the mean postoperative abdominal drainage volume was (126 ± 58) ml,and the mean length of hospital stay was (9.5±2.1) days.No allogenic blood was transfused in all patients.The postoperative complications such as massive bleeding,infection and pancreatic leakage were not found.Conclusion:The LS combined with IAT is a safe and feasible treatment option for hemodynamically stable patients with traumatic splenic rupture,have an advantage of faster recovery,shorter length of stay and less postoperative complications.关键词
脾脏损伤/脾脏切除术/腹腔镜/自体输血Key words
splenic injuries/splenectomy/laparoscope/autogous blood transfusion分类
医药卫生引用本文复制引用
范瑞芳,肖毅,许树林,党政,上官建营,张超,吕志诚,牛刚,李月胜..腹腔镜脾切除术联合术中自体输血治疗外伤性脾破裂的疗效研究[J].西北国防医学杂志,2017,38(11):719-722,4.
