Sözüer E M, Ok E, Banli O, Ince O, Kekeç Z
Erciyes Universitesi Tip Fakültesi Genel Cerrahi Anabilim Dali 38039, Kayseri.
Ulus Travma Derg. 2001 Jan;7(1):17-21.
Splenectomy is the frequently used surgical method for the treatment of traumatic splenic injuries. In this study, the patients who had traumatic splenic injuries were investigated and the results of surgical treatments were evaluated. There were 225 patients with traumatic splenic injuries, which contains 55 (24%) female and 170 (76%) male. The mean age was 29 (range 16-71) years. Severity of splenic injury was classified according to Moore organ injury scaling and there were 23 (10%) patients in grade 1, 96 (43%) in grade II, 75 (33%) in grade III, 24 (11%) in grade IV and 7 (3%) in grade V. Splenectomy was performed in 203 (90%) patients, splenoraphy in 18 (8%) and partial splenectomy in 4 (2%) patients. The overall mortality was 12%. A positive correlation was estimated between the combined trauma and the mortality (Fisher's Chi-Square test; chi 2 = 9,538, p < 0.002). In conclusion, non-operative treatment methods may prevent unnecessary splenectomies, especially in grade I and II blunt or penetrating splenic injuries. Combined injuries are the major factor increasing the mortality.
脾切除术是治疗外伤性脾损伤常用的手术方法。在本研究中,对患有外伤性脾损伤的患者进行了调查,并评估了手术治疗结果。共有225例外伤性脾损伤患者,其中女性55例(24%),男性170例(76%)。平均年龄为29岁(范围16 - 71岁)。脾损伤的严重程度根据Moore器官损伤分级进行分类,I级23例(10%),II级96例(43%),III级75例(33%),IV级24例(11%),V级7例(3%)。203例(90%)患者接受了脾切除术,18例(8%)接受了脾修补术,4例(2%)接受了部分脾切除术。总死亡率为12%。估计复合伤与死亡率之间存在正相关(Fisher卡方检验;卡方 = 9.538,p < 0.002)。总之,非手术治疗方法可能避免不必要的脾切除术,尤其是在I级和II级钝性或穿透性脾损伤中。复合伤是增加死亡率的主要因素。