Mustard R A, Hanna S S, Blair G, Harrison A W, Taylor G A, Miller H A, Maggisano R
Can J Surg. 1984 Jul;27(4):330-3.
To examine the morbidity and mortality associated with blunt splenic injuries, the authors reviewed the results in 106 such patients treated in the Sunnybrook Regional Trauma Unit between June 1, 1976 and June 30, 1983. Initial assessment included peritoneal lavage in 86 patients. No patient with known or suspected splenic injury was treated nonoperatively nor were any patients found to have had splenic injuries missed at the initial assessment. Seventy-one splenectomies and 35 splenorrhaphies were performed. The overall mortality was 25% and 10 surviving patients had serious complications. The splenic injury itself was never the cause of death. Only one patient who initially underwent splenorrhaphy later required splenectomy. It is concluded that blunt splenic injury is rarely the cause of death or serious morbidity when a policy of immediate diagnosis and operative treatment is carried out. Furthermore, in selected patients, splenorrhaphy is a safe and effective treatment.
为研究钝性脾损伤的发病率和死亡率，作者回顾了1976年6月1日至1983年6月30日期间在桑尼布鲁克地区创伤科接受治疗的106例此类患者的结果。初始评估包括对86例患者进行腹腔灌洗。没有已知或疑似脾损伤的患者接受非手术治疗，也没有发现任何患者在初始评估时漏诊脾损伤。实施了71例脾切除术和35例脾修补术。总死亡率为25%，10名存活患者出现严重并发症。脾损伤本身从未成为死亡原因。只有1例最初接受脾修补术的患者后来需要进行脾切除术。得出的结论是，当实施即时诊断和手术治疗策略时，钝性脾损伤很少是死亡或严重发病的原因。此外，在选定的患者中，脾修补术是一种安全有效的治疗方法。
