Wetzig N R, Strong R W, Theile D E
Aust N Z J Surg. 1986 Oct;56(10):781-4. doi: 10.1111/j.1445-2197.1986.tb02326.x.
A retrospective study of 301 adult splenic injuries presenting to the Princess Alexandra Hospital during a 15 year period, from 1970 to 1984, was conducted. Particular attention was paid to the last 5 years during which 25% of the ruptured spleens were preserved. The details of the preserved spleens are discussed. Respiratory infections were the only complications in this same selected group of patients; the complication rate being higher in the splenectomy group (15.8%) than the splenorrhaphy group (6.25%). None of the cases of splenorrhaphy required re-operation for continued haemorrhage. Twenty-five per cent of all cases of splenic injury had associated intra-abdominal injury which, of its own nature, would require laparotomy. A policy of operative management for splenic injury in adults with major trauma is therefore proposed because of the rate of associated intra-abdominal injuries. When laparotomy is performed, splenorrhaphy should be considered because of the now widely acknowledged risks of diminished immunological competence and overwhelming sepsis in asplenic individuals.
对1970年至1984年这15年间在亚历山德拉公主医院就诊的301例成人脾损伤患者进行了回顾性研究。特别关注了最后5年，在此期间25%的破裂脾脏得以保留。文中讨论了保留脾脏的详细情况。呼吸道感染是这同一组选定患者中仅有的并发症；脾切除组的并发症发生率（15.8%）高于脾修补术组（6.25%）。脾修补术的所有病例均未因持续出血而需要再次手术。25%的脾损伤病例伴有腹腔内损伤，就其自身性质而言，需要进行剖腹手术。因此，鉴于腹腔内联合损伤的发生率，建议对患有严重创伤的成人脾损伤采取手术治疗策略。当进行剖腹手术时，鉴于目前已被广泛认可的无脾个体免疫能力下降和暴发性败血症的风险，应考虑进行脾修补术。
