Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China (mainland).
Med Sci Monit. 2020 Feb 25;26:e922862. doi: 10.12659/MSM.922862.
BACKGROUND The aim of this study was to evaluate the feasibility and safety of intermittent splenic artery occlusion plus gauze compression in treating iatrogenic splenic injury. MATERIAL AND METHODS We retrospectively analyzed 12 iatrogenic splenic injury cases (grade I to III) treated with intermittent splenic artery occlusion plus gauze compression. The hemostatic effect was then observed after unblocking and decompression. The total operation time, gauze compression time, total blood loss, blood loss from the injured spleen, and platelet counts of each patient before and 1 week after surgery were noted. RESULTS The average operation time was 209.58±57.11 min, and the average gauze compression time after spleen artery occlusion was 23.75±4.33 min. The average total blood loss and blood loss due to iatrogenic spleen injury were 468.33±138.22 ml and 264.17±165.72 ml, respectively. Two cases (both grade I) had successful hemostasis after 15 min of splenic artery occlusion and wound compression. Another 9 cases (all grade II) and 1 case (grade III) attained hemostasis after 25 min and 30 min, respectively, of splenic artery occlusion and wound compression. The platelet counts of all patients were within the normal range before and 1 week after surgery. No postoperative complications occurred. CONCLUSIONS Intermittent splenic artery occlusion plus gauze compression is a simple and effective treatment for iatrogenic splenic injury.
本研究旨在评估间歇性脾动脉阻断加纱布压迫治疗医源性脾损伤的可行性和安全性。
我们回顾性分析了 12 例采用间歇性脾动脉阻断加纱布压迫治疗的医源性脾损伤（Ⅰ～Ⅲ级）患者。然后观察阻断和减压后的止血效果。记录每位患者的总手术时间、脾动脉阻断后纱布压迫时间、总出血量、损伤脾出血量和手术前后 1 周的血小板计数。
平均手术时间为 209.58±57.11 分钟，脾动脉阻断后纱布压迫平均时间为 23.75±4.33 分钟。平均总出血量和医源性脾损伤出血量分别为 468.33±138.22ml 和 264.17±165.72ml。2 例（均为Ⅰ级）脾动脉阻断和伤口压迫 15 分钟后成功止血。另外 9 例（均为Ⅱ级）和 1 例（Ⅲ级）脾动脉阻断和伤口压迫 25 分钟和 30 分钟后止血。所有患者手术前后血小板计数均在正常范围内。无术后并发症发生。
间歇性脾动脉阻断加纱布压迫是治疗医源性脾损伤的一种简单有效的方法。
