Division of Trauma, Department of Emergency, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2011 Aug;74(8):341-4. doi: 10.1016/j.jcma.2011.06.005. Epub 2011 Jul 27.
Spleen artery embolization (SAE) may increase the success rate of nonoperative management (NOM). The present study investigated the clinical outcome after the installation of SAE in the management of blunt splenic injury.
A retrospective review of hospital records was performed to enroll patients with blunt injury of the spleen. Demographic data and information about the injury severity score, organ injury scale, hospitalization days, management and final outcomes were evaluated. Patients were separated into early and late groups according to the year that SAE was selectively used (2003-2004 and 2005-2008).
Six of eleven (55%) patients in the early group were successfully managed without surgery for blunt splenic injury, whereas all of the 38 patients (100%) in the late group were successfully managed without surgery. Eleven patients (11 of 38; 28.9%) received SAE in the late group. The rate of NOM increased from 55% in the early group to 100% in the late group (p < 0.001). Both early and late groups had similar injury severity score, length of hospitalization, blood transfusion, and complications, and there was no mortality.
Performance of SAE for the patients with blunt splenic injury could increase the successful rate of NOM significantly and safely. An algorithm including the angioembolization might be beneficial in the management of patients with blunt spleen trauma.
脾动脉栓塞术（SAE）可提高非手术治疗（NOM）的成功率。本研究探讨了在钝性脾损伤的治疗中应用 SAE 后的临床结果。
对医院病历进行回顾性分析，纳入钝性脾损伤患者。评估人口统计学数据以及损伤严重程度评分、器官损伤评分、住院天数、治疗方法和最终结果等信息。根据 SAE 选择性使用的年份（2003-2004 年和 2005-2008 年）将患者分为早期和晚期组。
11 例早期组患者中有 6 例（55%）成功接受非手术治疗，而晚期组 38 例患者均成功接受非手术治疗（100%）。晚期组中有 11 例（38 例中的 11 例；28.9%）患者接受了 SAE。NOM 率从早期组的 55%上升至晚期组的 100%（p<0.001）。早期组和晚期组的损伤严重程度评分、住院时间、输血和并发症相似，且均无死亡病例。
对钝性脾损伤患者进行 SAE 可显著且安全地提高 NOM 的成功率。在钝性脾外伤的治疗中纳入血管栓塞术可能是有益的。
