Kristoffersen Kristian W, Mooney David P
Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
J Pediatr Surg. 2007 Jun;42(6):1038-41; discussion 1041-2. doi: 10.1016/j.jpedsurg.2007.01.039.
Nonoperative management (NOM) of blunt splenic trauma is the standard of care in hemodynamically stable children. The long-term risk of this strategy remains unknown. The object of this study was to investigate the incidence of long-term complications after NOM of pediatric splenic injury.
All children who underwent NOM for blunt splenic trauma over an 11-year period were identified. Patients were interviewed for any ailments that could be related to their splenic injury, and hospital data were analyzed.
A total of 266 patients were identified, and 228 patients (86%) were interviewed. Mean follow-up time was 5 +/- 3 years. One patient had a delayed complication, a splenic pseudocyst. Pain more than 4 weeks after injury was unusual. Time until return to full activity varied broadly.
The incidence of long-term complications after NOM of pediatric splenic injury was 1 (0.44%) in 228 patients. Nonoperative management of pediatric blunt splenic trauma in children is associated with a minimal risk of long-term complications.
对于血流动力学稳定的儿童，钝性脾外伤的非手术治疗（NOM）是标准治疗方法。该策略的长期风险尚不清楚。本研究的目的是调查小儿脾损伤非手术治疗后长期并发症的发生率。
确定了在11年期间接受钝性脾外伤非手术治疗的所有儿童。对患者进行了关于任何可能与其脾损伤相关疾病的访谈，并分析了医院数据。
共确定了266例患者，其中228例（86%）接受了访谈。平均随访时间为5±3年。1例患者出现延迟并发症，即脾假性囊肿。受伤后4周以上的疼痛并不常见。恢复完全活动的时间差异很大。
228例患者中，小儿脾损伤非手术治疗后长期并发症的发生率为1例（0.44%）。小儿钝性脾外伤的非手术治疗与长期并发症的风险极小相关。
