| 卢 骏,夏 婷,李 磊,曹崇琪,张功鹏,张召辉.脾动脉介入栓塞治疗外伤性脾破裂的临床效果及对患者免疫功能的影响[J].,2019,19(10):1937-1940 |
| 脾动脉介入栓塞治疗外伤性脾破裂的临床效果及对患者免疫功能的影响 |
| Clinical Efficacy of Splenic Artery Interventional Embolization in the Treatment of Traumatic Splenic Rupture and Its Influence on the Immune Function |
| 投稿时间：2018-09-28 修订日期：2018-10-23 |
| DOI：10.13241/j.cnki.pmb.2019.10.028 |
| 中文关键词: 脾动脉介入栓塞 外伤性脾破裂 免疫功能 |
| 英文关键词: Splenic artery interventional embolization Traumatic splenic rupture Immune function |
| 基金项目:南京军区医学科技创新重点项目(10Z009 YN2010002) |
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| 中文摘要: |
| 摘要 目的：探讨脾动脉介入栓塞治疗外伤性脾破裂的临床效果及对患者免疫功能的影响。方法：选择2013年4月到2017年2月在中国人民解放军第九七医院进行急诊治疗的116例外伤性脾破裂患者，根据治疗方法的不同将其分为观察组60例与对照组56例，对照组接受脾脏切除手术，观察组给予脾动脉介入栓塞治疗，记录和比较两组的术后下床活动时间、术后住院时间、术后肛门排便时间、术后肛门排气时间、术中输血量、手术时间与治疗前后CD4+/CD8+、CD8+、CD4+、CD3+的变化及不良反应的发生情况。结果：所有患者都完成治疗并抢救成功，观察组的术后下床活动时间、术后住院时间、术后肛门排便时间、术后肛门排气时间、术中输血量、手术时间都少于对照组(P<0.05)。观察组围手术期间的急性肠梗阻、急性胰腺炎、肺炎等并发症发生率为3.33%，对照组为17.86%，观察组低于对照组(P<0.05)。术后14天，两组白细胞与血小板含量均显著高于术前1天(P<0.05)，而观察组血小板含量显著低于对照组(P<0.05)，但两组白细胞含量比较差异无统计学意义(P>0.05)。观察组术后14天与术后1个月的CD4+/CD8+、CD4+、CD3+值均明显高于对照组(P<0.05)，两组CD8+对比差异无统计学意义(P>0.05)。结论：脾动脉介入栓塞治疗外伤性脾破裂能提高治疗的临床效果，减少术后并发症的发生，促进患者免疫功能的恢复。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical effect of splenic artery interventional embolization in the treatment of traumatic spleen rupture and its effect on the immune function. Methods: 116 cases of patients with traumatic splenic rupture who were treated in the 97th Hospital of the Chinese People's Liberation Army from April 2013 to February 2017 were selected. According to different treatment methods, they were divided into 60 cases in the observation group and 56 cases in the control group. The control group was given splenectomy, and the observation group was treated by splenic artery interventional embolization. The postoperative ambulation time, postoperative hospital time, postoperative anus defecation time, postoperative anus exhaust time, intraoperative blood transfusion, operation time, the changes of CD4+/CD8+, CD8+, CD4+, CD3+ before and after treatment and the occurrence of adverse reactions of the two groups were recorded and compared. Results: All patients completed the treatment and were successfully rescued. The postoperative activity out of bed days, the time of hospitalization after operation, the time of postoperative anus defecation, the time of postoperative anus exhaust, the amount of blood transfusion and the operation time of the observation group were less than those of the control group (P<0.05). In the observation group, the incidence of acute intestinal obstruction, acute pancreatitis, pneumonia and other complications during the perioperative period was 3.33%, it was 17.86% in the control group and was higher than that of the observation group (P<0.05). On the 14th day after operation, the content of white blood cells and platelets in both groups were significantly higher than those on 1 day before operation (P<0.05), but the content of platelet in the observation group was significantly lower than that of the control group (P<0.05), but there was no significant difference in the white blood cell content between the two groups (P>0.05). The CD4+/CD8+, CD4+ and CD3+ of observation group at 14 days after operation and 1 month after the operation were significantly higher than those in the control group (P<0.05), and there was no significant difference in the CD8+ between the two groups (P>0.05). Conclusion: Splenic artery interventional embolization can improve the clinical effect in the treatment of traumatic spleen rupture, it can reduce the occurrence of postoperative complications and promote the recovery of immune function. |
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