Terry N Elizabeth, Boswell William C
Department of Surgery, Division of Pediatric Surgery, Memorial Health University Medical Center, Mercer University School of Medicine, Savannah, GA 31404, USA.
J Pediatr Surg. 2006 Sep;41(9):1607-9. doi: 10.1016/j.jpedsurg.2006.05.061.
Nonoperative management of splenic lacerations has become the standard of care in hemodynamically stable patients. The decision to manage a patient nonoperatively is much more difficult when the patient has a known bleeding disorder. There are a few case reports in the literature describing nonoperative management of splenic trauma in children with hemophilia A (factor VIII deficiency), but only one case report of a patient with hemophilia B (factor IX deficiency) and a splenic laceration successfully managed nonoperatively. We present the case of a 13-year-old boy who presented with a grade 4 splenic laceration, acute blood loss anemia, and hypotension that was managed nonoperatively.
对于血流动力学稳定的患者，脾破裂的非手术治疗已成为标准治疗方法。当患者已知有出血性疾病时，决定对其进行非手术治疗要困难得多。文献中有几例病例报告描述了对患有甲型血友病（因子VIII缺乏症）的儿童脾外伤进行非手术治疗的情况，但仅有一例关于乙型血友病（因子IX缺乏症）患者脾破裂成功进行非手术治疗的病例报告。我们报告一例13岁男孩的病例，该男孩出现4级脾破裂、急性失血性贫血和低血压，经非手术治疗。
