Sofer M, Michowitz M, Mandelbaum Y, Fine N, Lelcuk S
Department of Surgery C, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Am Surg. 1998 Dec;64(12):1212-4.
Preservation of the spleen in patients with posttraumatic subcapsular hematoma is still controversial. To determine the best therapeutic approach for this type of splenic injury, we designed an experimental model of subcapsular hematoma of the spleen in dogs. A total of 23 subcapsular hematomas were caused in 19 dogs, which were followed both clinically and ultrasonographically for 12 weeks. Fifty-seven per cent of the hematomas resolved spontaneously; those that persisted (43%) were aspirated percutaneously with ultrasound guidance, after which they were all resolved. Our results support a conservative approach. When the hematoma does not resolve spontaneously, percutaneous ultrasound-guided aspiration may be considered.
创伤后脾包膜下血肿患者保留脾脏仍存在争议。为确定此类脾损伤的最佳治疗方法，我们设计了犬脾包膜下血肿的实验模型。在19只犬身上共造成23处脾包膜下血肿，对其进行了为期12周的临床和超声随访。57%的血肿自行消退；持续存在的血肿（43%）在超声引导下经皮抽吸，之后均得以消退。我们的结果支持保守治疗方法。当血肿不能自行消退时，可考虑超声引导下经皮抽吸。
