330例外伤性脾破裂临床急救分析(1)
[摘要] 目的 对外伤性脾破裂的临床急救进行分析，探讨其临床特点和预后。方法 对该院收治的330例外伤性脾破裂患者临床急救及预后情况进行回顾性分析。患者入院后予以紧急诊断和处理，依据病情不同给予不同治疗方式。 结果 330例外伤性脾破裂患者中，12例由于失血过多或合并肝破裂、严重的胸部外伤、严重颅脑损伤而死亡；单纯缝合修补术后5例出现脾血肿，经非手术积极治疗后血肿自行消失，其余患者均痊愈。 结论 外伤性脾破裂的患者通常情况比较危急，临床快速明确诊断，根据患者临床状况决定治疗方式，密切观察体征，对提高患者预后意义重大。
[关键词] 外伤性脾破裂；创伤急救；脾切除；脾修补术
[中图分类号] R657.6 [文献标识码] A [文章编号] 1674-0742(2014)07(a)-0023-02
[Abstract] Objective To analyze the clinical emergency treatment for traumatic rupture of spleen， and investigate the clinical features and prognosis of the disease. Methods The clinical characteristics， treatment process and prognosis of 330 cases of traumatic rupture of spleen admitted in Department of General Surgery and Emergency Department of our hospital from January， 2010 to December， 2013 were analyzed and studied retrospectively. After admission， the patients were given emergent diagnosis and treatment， and then given different treatment according to different disease conditions. Results Of the 330 patients with traumatic rupture of spleen， 12 patients died due to excessive bleeding or complicated by hepatic rupture， severe chest trauma， severe brain injury； 5 cases had spleen hematoma after simple suture neoplasty， and the hematoma disappeared spontaneously after positive non-surgical treatment， and the remaining patients were cured. Conclusion The condition of the patients with traumatic rupture of spleen is usually critical， when giving the patients emergent treatment， the events about trauma should be asked in detail， the damage extent of the spleen should be made clear， and the injury in other sites should be examined and made sure， the treatment method should be chosen according to the physical condition of the patients； changes of physical indicators of the patients underwent non-surgical treatment should be strictly monitored， the preparation of changing to surgical treatment in emergency should be done well； the spleen is to be preserved as far as possible according to the injury of the patients when they undergo the surgical treatment.
[Key words] Traumatic rupture of spleen； Trauma emergency treatment； Splenectomy； Spleen repair
由于脾脏内含血窦血管十分丰富，血流量大，所以一旦出现脾破裂损伤，很短时间内就容易就发展成不可控制的失血，造成失血性休克，甚至危及生命[1]。同时，脾脏又是人体中重要的免疫器官，脾切除的患者术后发生凶险性感染(OPSI)的几率明显增加[2-3]。临床应根据患者受伤情况，争取进行保脾治疗，进行部分切除后缝合修补。为了更好的救治脾破裂的患者，该院普外科联合急诊科开展了外伤后脾破裂紧急救助绿色通道，从而为脾破裂的患者争取更多的抢救时间。现选取该院自2010年1月—2013年12月因外伤入院，检查后明确为脾破裂并给予积极治疗的患者330例进行回顾性分析，临床治疗疗效满意，现报告如下。
1 资料与方法
1.1 一般资料, 百拇医药(陈汀劳等)
[关键词] 外伤性脾破裂；创伤急救；脾切除；脾修补术
[中图分类号] R657.6 [文献标识码] A [文章编号] 1674-0742(2014)07(a)-0023-02
[Abstract] Objective To analyze the clinical emergency treatment for traumatic rupture of spleen， and investigate the clinical features and prognosis of the disease. Methods The clinical characteristics， treatment process and prognosis of 330 cases of traumatic rupture of spleen admitted in Department of General Surgery and Emergency Department of our hospital from January， 2010 to December， 2013 were analyzed and studied retrospectively. After admission， the patients were given emergent diagnosis and treatment， and then given different treatment according to different disease conditions. Results Of the 330 patients with traumatic rupture of spleen， 12 patients died due to excessive bleeding or complicated by hepatic rupture， severe chest trauma， severe brain injury； 5 cases had spleen hematoma after simple suture neoplasty， and the hematoma disappeared spontaneously after positive non-surgical treatment， and the remaining patients were cured. Conclusion The condition of the patients with traumatic rupture of spleen is usually critical， when giving the patients emergent treatment， the events about trauma should be asked in detail， the damage extent of the spleen should be made clear， and the injury in other sites should be examined and made sure， the treatment method should be chosen according to the physical condition of the patients； changes of physical indicators of the patients underwent non-surgical treatment should be strictly monitored， the preparation of changing to surgical treatment in emergency should be done well； the spleen is to be preserved as far as possible according to the injury of the patients when they undergo the surgical treatment.
[Key words] Traumatic rupture of spleen； Trauma emergency treatment； Splenectomy； Spleen repair
由于脾脏内含血窦血管十分丰富，血流量大，所以一旦出现脾破裂损伤，很短时间内就容易就发展成不可控制的失血，造成失血性休克，甚至危及生命[1]。同时，脾脏又是人体中重要的免疫器官，脾切除的患者术后发生凶险性感染(OPSI)的几率明显增加[2-3]。临床应根据患者受伤情况，争取进行保脾治疗，进行部分切除后缝合修补。为了更好的救治脾破裂的患者，该院普外科联合急诊科开展了外伤后脾破裂紧急救助绿色通道，从而为脾破裂的患者争取更多的抢救时间。现选取该院自2010年1月—2013年12月因外伤入院，检查后明确为脾破裂并给予积极治疗的患者330例进行回顾性分析，临床治疗疗效满意，现报告如下。
1 资料与方法
1.1 一般资料, 百拇医药(陈汀劳等)
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