Dunham C M, Cornwell E E, Militello P
Division of Surgery, Shock Trauma Center, Maryland Institute for Emergency Medical Services Systems, Baltimore 21201-1595.
Surg Gynecol Obstet. 1991 Sep;173(3):179-82.
To assess the effect of the Argon Beam Coagulator (ABC) (Bircher Medical Systems) on splenic salvage, 160 adults sustaining blunt traumatic splenic injuries over a 39 month period were evaluated. The survey period includes the first 15 months during which the ABC was used and the immediate 24 months before the use of the ABC (pre-ABC). In addition to the difference in splenic salvage in the two groups with deep laceration without hilar injury (15 versus 53 per cent), the Injury Severity Score (ISS) (44.2 versus 34.5) and Glasgow Coma Score (GCS) (11.4 versus 13.8) were significant. Multivariate logistic regression analysis revealed a significant relationship between splenic salvage and ISS (r2 = 0.27, p = 0.001) with ABC (r2 = 0.07, p = 0.02). However, if GCS is added to ISS and ABC as a factor, it does not provide additional information (p = 0.37). We conclude that the use of the ABC in the management of blunt nonhilar splenic injuries significantly improves the prospect for successful splenorrhaphy.
为评估氩离子束凝固器（ABC，Bircher医疗系统公司生产）对脾脏保留的效果，我们对160例在39个月期间遭受钝性创伤性脾损伤的成年人进行了评估。调查期包括使用ABC的前15个月以及使用ABC之前紧接着的24个月（ABC前）。除了两组无脾门损伤的深部裂伤患者在脾脏保留方面存在差异（15%对53%）外，损伤严重度评分（ISS）（44.2对34.5）和格拉斯哥昏迷评分（GCS）（11.4对13.8）也有显著差异。多因素逻辑回归分析显示，脾脏保留与ISS（r2 = 0.27，p = 0.001）以及ABC（r2 = 0.07，p = 0.02）之间存在显著关系。然而，如果将GCS作为一个因素与ISS和ABC一起考虑，它并不能提供额外信息（p = 0.37）。我们得出结论，在处理钝性非脾门脾损伤时使用ABC可显著提高脾修补术成功的可能性。
