脾脏创伤:WSES 分类和成人及儿童患者治疗指南。

Splenic trauma: WSES classification and guidelines for adult and pediatric patients.

机构信息

General, Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy.

Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy.

出版信息

World J Emerg Surg. 2017 Aug 18;12:40. doi: 10.1186/s13017-017-0151-4. eCollection 2017.

Abstract

Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.

摘要

脾脏损伤是最常见的与创伤相关的损伤之一。目前,它们是根据损伤的解剖结构进行分类的。然而,最佳的治疗策略应考虑到血流动力学状态、解剖结构紊乱和相关损伤。脾脏创伤患者的管理旨在恢复内环境平衡和正常的生理病理状态,特别是考虑到现代出血管理工具。因此,脾脏创伤的管理最终应该是多学科的,并基于患者的生理学、损伤的解剖结构和相关病变。最后,由于成人和儿童的处理方式必须不同,儿童应始终在专门的儿科创伤中心进行治疗。事实上,绝大多数钝性脾创伤的儿童患者可以非手术治疗。本文介绍了世界急诊外科学会(WSES)的脾脏创伤分类和治疗指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e07/5562999/ac04726be5ea/13017_2017_151_Fig1_HTML.jpg

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