脾脏损伤的非手术治疗作用
The role of nonoperative management of the injured spleen.
作者信息
Cornwell E E
机构信息
Division of Trauma-Critical Care, Howard University College of Medicine, Washington, DC 20060.
出版信息
J Natl Med Assoc. 1993 Apr;85(4):297-9.
The role of selective nonoperative management of blunt splenic injuries in adults has been the focus of considerable controversy over the last decade. This article reviews the markedly contrasting experiences of proponents and opponents of this approach. When strict selection criteria are applied (ie, hemodynamic stability, opportunity for close observation, and radiographic confirmation of severity of injury), nonoperative management of blunt splenic injuries can be expected to be successful in more than 80% of cases where it is applied. However, these same criteria would select only about one-quarter of adults with blunt splenic injuries for nonoperative management, and mandate early surgery in the remaining three fourths. There is a limited role for nonoperative management of adults with blunt splenic injuries. The greatest contribution to increasing splenic salvage, however, can be expected to come from improved techniques in operative splenic repair.
在过去十年中，成人钝性脾损伤的选择性非手术治疗的作用一直是相当大争议的焦点。本文回顾了这种方法的支持者和反对者截然不同的经验。当应用严格的选择标准时（即血流动力学稳定、密切观察的机会以及损伤严重程度的影像学确认），钝性脾损伤的非手术治疗在应用的病例中超过80%有望成功。然而，这些相同的标准只会选择大约四分之一的钝性脾损伤成人进行非手术治疗，并要求其余四分之三的患者尽早手术。成人钝性脾损伤的非手术治疗作用有限。然而，增加脾挽救的最大贡献预计将来自手术脾修复技术的改进。
Zotero 插件