中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
4期
313-317
,共5页
林恒甫%陈盈达%林耿立%陈石池
林恆甫%陳盈達%林耿立%陳石池
림항보%진영체%림경립%진석지
腹部损伤%脾%破裂%腹腔镜
腹部損傷%脾%破裂%腹腔鏡
복부손상%비%파렬%복강경
Abdominal injuries%Spleen%Rupture%Laparoscopes
目的 评价腹腔镜下三明治缝合技术在严重钝性脾脏破裂保脾手术治疗中的应用与效果. 方法 回顾性分析24例因钝性伤造成脾脏严重破裂非手术治疗失败后,接受腹腔镜下三明治缝合修补技术行止血与保脾手术患者,评价腹腔镜下三明治缝合保脾手术的技巧、手术结果、术后恢复及随访结果等. 结果 24例患者中,21例(88％)行腹腔镜下三明治缝合修补技术完成止血及保脾,2例因脾脏破裂伤复杂须转为腹腔镜下脾脏切除术,1例因术中血流动力学不稳定转为剖腹手术切除脾脏.止血时间(36.7 ±22.0) min,手术时间(136.3 ±40.3) min;术中失血量(1 598.0±940.0) ml;住院天数(10.8±5.4)d.患者均康复出院,无死亡.随访3个月,无再出血、脾脏完全梗死、脾脏脓肿等并发症发生. 结论 腹腔镜下三明治缝合修补技术可有效应用于严重钝性伤患者的保脾手术.
目的 評價腹腔鏡下三明治縫閤技術在嚴重鈍性脾髒破裂保脾手術治療中的應用與效果. 方法 迴顧性分析24例因鈍性傷造成脾髒嚴重破裂非手術治療失敗後,接受腹腔鏡下三明治縫閤脩補技術行止血與保脾手術患者,評價腹腔鏡下三明治縫閤保脾手術的技巧、手術結果、術後恢複及隨訪結果等. 結果 24例患者中,21例(88％)行腹腔鏡下三明治縫閤脩補技術完成止血及保脾,2例因脾髒破裂傷複雜鬚轉為腹腔鏡下脾髒切除術,1例因術中血流動力學不穩定轉為剖腹手術切除脾髒.止血時間(36.7 ±22.0) min,手術時間(136.3 ±40.3) min;術中失血量(1 598.0±940.0) ml;住院天數(10.8±5.4)d.患者均康複齣院,無死亡.隨訪3箇月,無再齣血、脾髒完全梗死、脾髒膿腫等併髮癥髮生. 結論 腹腔鏡下三明治縫閤脩補技術可有效應用于嚴重鈍性傷患者的保脾手術.
목적 평개복강경하삼명치봉합기술재엄중둔성비장파렬보비수술치료중적응용여효과. 방법 회고성분석24례인둔성상조성비장엄중파렬비수술치료실패후,접수복강경하삼명치봉합수보기술행지혈여보비수술환자,평개복강경하삼명치봉합보비수술적기교、수술결과、술후회복급수방결과등. 결과 24례환자중,21례(88％)행복강경하삼명치봉합수보기술완성지혈급보비,2례인비장파렬상복잡수전위복강경하비장절제술,1례인술중혈류동역학불은정전위부복수술절제비장.지혈시간(36.7 ±22.0) min,수술시간(136.3 ±40.3) min;술중실혈량(1 598.0±940.0) ml;주원천수(10.8±5.4)d.환자균강복출원,무사망.수방3개월,무재출혈、비장완전경사、비장농종등병발증발생. 결론 복강경하삼명치봉합수보기술가유효응용우엄중둔성상환자적보비수술.
Objective To evaluate the effect of laparoscopic sandwich repair technique in spleen salvage for patients with high-grade blunt splenic trauma.Methods A retrospective study was performed in 24 patients with high-grade blunt splenic trauma undergone sandwich repair laparoscopically for hemostasis and spleen preservation after the failed non-operative therapy.Surgical techniques,surgical outcomes,postoperative recovery,and follow-up results were evaluated.Results Of all,21 patients (88％) underwent laparoscopic sandwich repair for hemostasis and spleen preservation successfully; 2 were converted to the laparoscopic splenectomy due to complex splenic rupture; 1 was converted to an open splenectomy due to unstable hemodynamics.Mean time to reach hemostasis was (36.7 ± 22.0) minutes and operation time was (136.3 ±40.3) minutes; mean blood loss was (1 598.0 ±940.0) ml and length of hospital stay was (10.8 ± 5.4) days.All patients were recovered at discharge.There were no complications of re-bleeding,total splenic infarction,or abdominal abscess at the 3-month follow-up.Conclusion Laparoscopic sandwich repair technique can be used effectively for spleen salvage in patients with high-grade splenic trauma.
