Schimmer J A G, van der Steeg A F W, Zuidema W P
Department of Trauma Surgery, VU University Medical Centre, Amsterdam, The Netherlands.
Department of Paediatric Surgery, Paediatric Surgical Centre of Amsterdam, Emma Children's Hospital AMC and VU University Medical Centre, Amsterdam, The Netherlands.
Injury. 2016 Mar;47(3):525-30. doi: 10.1016/j.injury.2015.10.047. Epub 2015 Nov 19.
Splenic artery embolization (SAE), proximal or distal, is becoming the standard of care for traumatic splenic injury. Theoretically the immunological function of the spleen may be preserved, but this has not yet been proven. A parameter for measuring the remaining splenic function must therefore be determined in order to decide whether or not vaccinations and/or antibiotic prophylaxis are necessary to prevent an overwhelming post-splenectomy infection (OPSI).
A systematic review of the literature was performed July 2015 by searching the Embase and Medline databases. Articles were eligible if they described at least two trauma patients and the subject was splenic function. Description of procedure and/or success rate of SAE was not necessary for inclusion. Two reviewers independently assessed the eligibility and the quality of the articles and performed the data extraction.
Twelve studies were included, eleven with adult patients and one focusing on children. All studies used different parameters to assess splenic function. None of them reported a OPSI after splenic embolization. Eleven studies found a preserved splenic function after SAE, in both adults and children.
All but one studies on the long term effects of SAE indicate a preserved splenic function. However, there is still no single parameter or test available which can demonstrate that unequivocally.
脾动脉栓塞术（SAE），无论近端或远端，正成为创伤性脾损伤的标准治疗方法。理论上脾脏的免疫功能可能得以保留，但这尚未得到证实。因此，必须确定一个衡量脾脏剩余功能的参数，以决定是否需要接种疫苗和/或预防性使用抗生素来预防脾切除术后暴发性感染（OPSI）。
2015年7月通过检索Embase和Medline数据库对文献进行了系统综述。如果文章描述了至少两名创伤患者且主题为脾功能，则该文章符合入选标准。纳入研究无需描述SAE的操作过程和/或成功率。两名评审员独立评估文章的入选资格和质量，并进行数据提取。
纳入了12项研究，其中11项针对成年患者，1项聚焦于儿童。所有研究都使用不同的参数来评估脾功能。它们均未报告脾栓塞术后发生OPSI。11项研究发现，SAE术后无论是成人还是儿童，脾功能均得以保留。
除一项研究外，所有关于SAE长期影响的研究均表明脾功能得以保留。然而，目前仍没有单一的参数或检测方法能够明确证实这一点。
