CAJ | 학술논문

　　目的探讨非手术治疗闭合性脾损伤的病例遴选、监测和诊治方法。方法对1999年10月至2011年10月采用非手术治疗的98例闭合性脾损伤患者临床资料进行回顾性总结分析。结果98例患者中，经非手术治疗痊愈出院90例（91．8％）；经治疗观察后发现血肿增大和持续渗血而中转开腹5例（5．1％）；死亡3例（3．1％），为多发伤合并感染和器官功能衰竭患者。结论大多数Ⅱ级以下脾损伤可通过非手术治疗治愈，只要病例遴选合适、诊治方法得当、监护条件完备，选择性非手术治疗脾损伤是安全可行的。
　　목적탐토비수술치료폐합성비손상적병례린선、감측화진치방법。방법대1999년10월지2011년10월채용비수술치료적98례폐합성비손상환자림상자료진행회고성총결분석。결과98례환자중，경비수술치료전유출원90례（91．8％）；경치료관찰후발현혈종증대화지속삼혈이중전개복5례（5．1％）；사망3례（3．1％），위다발상합병감염화기관공능쇠갈환자。결론대다수Ⅱ급이하비손상가통과비수술치료치유，지요병례린선합괄、진치방법득당、감호조건완비，선택성비수술치료비손상시안전가행적。
Objective To discusses the methods of the case selection and monitoring and diagnosis and treatment to selective non-operative management of closed splenic injuries .Methods The clinical data and results of 98 cases from October 1999 to Octo-ber 2011 with closed splenic injuries managed non-operative treatment were analyzed retrospectively .Results There were 90 cases (91 .8% ) conservative successfully ,5 cases(5 .1% ) transit operation because hematoma increase and bleeding continuously during therapeutic observation and 2 cases(3 .1% ) died from multiple injuries merge infection and multiple organ failure .Conclusion Most of the closed splenic injuries below level Ⅱcan be treated by non-operative management ,the effect and prognosis determined by the reasonable case selection and monitoring conditions and diagnosis and treatment .