Mufti Tariq Saeed, Akbar Ismail, Ahmed Sajjad
Department of Surgery, Ayub Teaching Hospital, Abbottabad.
J Ayub Med Coll Abbottabad. 2007 Jul-Sep;19(3):3-5.
This study was carried out to estimate the prevalence, severity and mode of splenic trauma and management technique from amongst the abdominal trauma cases admitted in Ayub Teaching Hospital.
The study was carried out at Surgery units of Ayub Teaching Hospital, Abbottabad, the only referral hospital for major trauma cases, from July 2001 to Dec. 2002. One hundred consecutive abdominal trauma patients admitted to all surgical units which were followed up through complete documentation were included in the study. Their injuries were classified, treatment strategies outlined and complications were documented.
Out of the 100 patients presenting in emergency, 25% presented with blunt and 75% with penetrating trauma. 97 patients underwent laparotomy and 03 treated conservatively. Mean age was 27.26 (range 19-49) years. Out of these cases 19 patients had splenic injury, 6 (31.57%) with Type-I & II while 13 (68.42%) with Type-III & IV. 11(57.89%) of the splenic injuries were due to blunt abdominal trauma and 8 (42.10%) due to penetrating abdominal injuries. 14 (83.6%) of the patients with splenic injury underwent splenectomy and 5(26.3%) splenorrhaphy.
The commonest cause of splenic injury was blunt abdominal trauma; Assessment of the severity of splenic injuries at the time of laparotomy resulted in splenic salvage procedures in some cases. Splenorraphy was associated with fewer complications.
本研究旨在评估阿尤布教学医院收治的腹部创伤病例中脾损伤的发生率、严重程度、损伤方式及处理技术。
本研究于2001年7月至2002年12月在阿尤布教学医院外科病房进行,该医院是主要创伤病例的唯一转诊医院。连续纳入100例入住所有外科病房的腹部创伤患者,通过完整记录进行随访。对他们的损伤进行分类,概述治疗策略并记录并发症。
在100例急诊患者中,25%为钝性创伤,75%为穿透性创伤。97例患者接受了剖腹手术,3例保守治疗。平均年龄为27.26岁(范围19 - 49岁)。在这些病例中,19例有脾损伤,6例(31.57%)为Ⅰ型和Ⅱ型,13例(68.42%)为Ⅲ型和Ⅳ型。11例(57.89%)脾损伤是由钝性腹部创伤引起,8例(42.10%)由穿透性腹部损伤引起。14例(83.6%)脾损伤患者接受了脾切除术,5例(26.3%)接受了脾修补术。
脾损伤最常见的原因是钝性腹部创伤;剖腹手术时对脾损伤严重程度的评估在某些情况下导致了脾保留手术。脾修补术的并发症较少。