文章摘要
马建中,张 宇,韩圣瑾,魏鲲鹏,李后俊.脾全切除术与脾部分切除术治疗外伤性脾破裂的临床疗效对比[J].,2017,17(24):4706-4709
脾全切除术与脾部分切除术治疗外伤性脾破裂的临床疗效对比
Comparison of Clinical Efficacy between Spleen Total Resection and Spleen Partial Splenectomy in Treatment of Traumatic Spleen Rupture
投稿时间:2017-02-28  修订日期:2017-03-20
DOI:10.13241/j.cnki.pmb.2017.24.026
中文关键词: 外伤性脾破裂  脾全切除术  脾部分切除术  血小板  免疫功能
英文关键词: Traumatic spleen rupture  Spleen total resection  Spleen total resection  Platelets  Immune function
基金项目:安徽省自然科学基金项目(070413129)
作者单位
马建中 安徽医科大学附属六安市人民医院 急诊外科 安徽 六安237000 
张 宇 安徽医科大学附属六安市人民医院 急诊外科 安徽 六安237000 
韩圣瑾 安徽医科大学附属六安市人民医院 急诊外科 安徽 六安237000 
魏鲲鹏 安徽医科大学附属六安市人民医院 急诊外科 安徽 六安237000 
李后俊 安徽医科大学附属六安市人民医院 急诊外科 安徽 六安237000 
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中文摘要:
      摘要 目的:比较脾全切除术和脾部分切除术治疗外伤性脾破裂的临床疗效和安全性。方法:选择我院2013年3月~2016年3月收治的84例外伤性脾破裂患者并平均分为两组,脾全切除组42例采用脾全切除术治疗,脾部分切除组42例采用脾部分切除术治疗,比较两组的手术效果、治疗前后血小板计数、血清IgA、IgG、IgM、CD3+、CD4+、CD8+及CD4+/CD8+水平的变化以及术后并发症的发生情况。结果:部分切除组术中失血量、排气时间、住院时间均短于全切除组,但部分切除组手术时间显著长于全切除组,差异有统计学意义(P<0.05)。部分切除组血小板计数、IgM、CD8+水平明显低于对照组,IgA、IgG、CD3+、CD4+、CD8+、CD4+/CD8+显著高于全切除组(P<0.05)。部分切除组并发症发生率显著低于全切除组(P<0.05)。结论:脾部分切除术治疗外伤性脾裂的手术效果优于脾全切除术,且对患者血小板及免疫功能的影响较小。
英文摘要:
      ABSTRACT Objective: To compare the clinical efficacy and safety between spleen total resection splenectomy and spleen partial splenectomy in the treatment of patients with traumatic spleen rupture. Methods: 84 cases of patients with traumatic spleen rupture from March 2013 to March 2016 were selected and divided into two groups. 42 cases in the spleen total resection group were treated with spleen total resection, while the other 42 cases in the spleen partial nephrectomy group were treated with spleen partial splenectomy. The operative effect, the levels of platelet count, serum IgA, IgG, IgM, CD3 +, CD4 +, CD8 +, CD4 + / CD8 + levels before and after treatment, the incidence of complications were compared between two groups. Results: The intraoperative blood loss, exhaust time, length of hospital stay of spleen partial nephrectomy group were shorter than those of the spleen total resection group, but the operation time of research group was longer than that of the spleen total resection group(P<0.05). The platelet count, CD8+ of spleen partial nephrectomy group were lower than those of the spleen total resection group(P<0.05). The IgA, IgG, IgM, CD3+, CD4+, CD8+, CD4+/CD8+ of spleen partial nephrectomy group were significantly higher than those of the spleen total resection group (P<0.05). The incidence rate of complications in the spleen partial nephrectomy group was lower than that of the spleen total resection group (P<0.05). Conclusion: Spleen partial splenectomy was more effective than spleen total resection in the treatment of traumatic splenic rupture, which had little effect on the platelet and immune function.
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