Stylianos S, Hoffman M A, Jacir N N, Harris B H
Division of Pediatric Surgery, Tufts University School of Medicine, Floating Hospital, Boston, MA.
J Pediatr Surg. 1991 Jan;26(1):87-9. doi: 10.1016/0022-3468(91)90435-v.
Splenic salvage following blunt injury can fail when parenchymal bleeding is uncontrollable. To define the usefulness of an argon beam coagulator for hemostasis, we used the instrument in a laboratory trial of partial splenic resection. New Zealand white rabbits, weighing 4 to 5 kg, had sharp excision of the lower half of the spleen. No sutures were used to control hemorrhage from the cut splenic surface or the hilar vessels. Hemostasis was achieved with 2 to 4 seconds of electrocoagulation delivered by a beam of argon gas. All animals survived the procedure and were in good health when killed between the fourth and sixth week following the procedure. At necropsy, the spleen was viable in all animals with no abscess or hematoma. Minimal adhesions from the treated splenic surface to the omentum were found. The scar at the cut surface was 1 mm in depth, and the histology of the remainder of the spleen was normal. In this simulated splenic injury model, argon beam coagulation was uniformly successful in achieving hemostasis. Minimal tissue destruction and lack of infection were noted. The argon beam coagulator may be useful in patients with severe splenic injuries and other situations requiring partial splenectomy.
钝性损伤后脾脏挽救术在实质出血无法控制时可能会失败。为了确定氩气刀在止血方面的效用，我们在部分脾切除的实验室试验中使用了该器械。体重4至5千克的新西兰白兔，其脾脏下半部分被锐性切除。未使用缝线来控制脾脏切面或脾门血管的出血。通过氩气束进行2至4秒的电凝来实现止血。所有动物均在手术后存活，并且在术后第四至六周处死时健康状况良好。尸检时，所有动物的脾脏均存活，无脓肿或血肿。发现处理过的脾脏表面与大网膜之间仅有轻微粘连。切面处的瘢痕深度为1毫米，脾脏其余部分的组织学检查正常。在这个模拟脾损伤模型中，氩气束凝固在实现止血方面均取得成功。观察到组织破坏最小且无感染。氩气刀可能对严重脾损伤患者及其他需要进行部分脾切除术的情况有用。
