Solheim K, Høivik B
Injury. 1985 Jan;16(4):221-6. doi: 10.1016/s0020-1383(85)80002-4.
In this series of 80 consecutive patients with injured spleens scintigraphy was the diagnostic mainstay and was performed in 63 patients. Fifty-five patients were initially managed without operation. Two of them, however, underwent laparotomy respectively 1 and 2 days after admission because of increasing symptoms and signs. Twenty-seven patients underwent laparotomy, with successful conservative surgery in 8 and splenectomy in 19. However, in at least five of these it was thought in retrospect that repair of the spleen might have been possible. There were no deaths or serious morbidity from the injury to the spleen. It is concluded that no operation or operative repair of the spleen is the treatment of choice in the majority of patients with blunt injuries. In order to avoid loss of life as well as loss of the spleen, strict adherence to an aggressive, exact diagnostic process, using non-invasive diagnostic imaging and close clinical observation, as well as experienced, painstaking surgical techniques, is necessary.
在这组连续的80例脾损伤患者中，闪烁扫描是主要的诊断方法，63例患者接受了该项检查。55例患者最初未进行手术治疗。然而，其中2例患者分别在入院后1天和2天因症状和体征加重而接受了剖腹手术。27例患者接受了剖腹手术，8例成功进行了保守性手术，19例进行了脾切除术。然而，事后认为其中至少有5例患者的脾脏可能本可以修复。脾损伤未导致死亡或严重并发症。结论是，对于大多数钝性脾损伤患者，不进行手术或手术修复是首选治疗方法。为了避免生命丧失以及脾脏切除，必须严格遵循积极、准确的诊断流程，采用非侵入性诊断成像和密切的临床观察，以及经验丰富、细致的手术技术。
