Tan K K, Chiu M T, Vijayan A
Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433.
Med J Malaysia. 2010 Dec;65(4):304-6.
Forty-two patients with traumatic blunt splenic injuries were admitted over a six year period. Vehicular-related collisions and fall from height accounted for the injuries in 38 (90.5%) of them. Eleven (26.2%) underwent immediate surgery (7 splenectomy and 4 splenorrhaphy), while the remaining 31 patients were treated nonoperatively of which 3 underwent angio-embolisation. Twenty seven patients had either grade III or IV splenic injuries. Operative management was more likely in patients with lower haemoglobin or with more severe splenic injury. Nonoperative management can be adopted in patients with blunt isolated splenic injuries but operative management is still indispensable in certain instances.
在六年期间，收治了42例创伤性钝性脾损伤患者。其中38例（90.5%）的损伤是由车辆相关碰撞和高处坠落所致。11例（26.2%）患者接受了急诊手术（7例行脾切除术，4例行脾修补术），其余31例患者接受非手术治疗，其中3例接受了血管栓塞治疗。27例患者存在Ⅲ级或Ⅳ级脾损伤。血红蛋白水平较低或脾损伤较严重的患者更有可能接受手术治疗。钝性单纯脾损伤患者可采用非手术治疗，但在某些情况下手术治疗仍然不可或缺。
