Traumatic splenic rupture, conservative vs surgical therapy
10.3760/cma.j.issn.1007-631X.2017.11.011
- VernacularTitle:外伤性脾破裂患者治疗策略的影响因素分析
- Author:
Changlin DENG
1
;
Hongwen ZOU
;
Xiaojiao LI
;
Shurong ZHOU
;
Shuping ZHANG
Author Information
1. 解放军第四二二医院普外科
- Keywords:
Splenic rupture;
Wounds and injuries
- From:
Chinese Journal of General Surgery
2017;32(11):937-940
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate management stratagy for patients with traumatic splenic rupture.Methods The clinical data of 124 patients with traumatic splenic rupture admitted to the 422 Hospital of PLA from April 2008 to June 2016 were retrospectively analyzed.38 patients were treated conservatively,while 86 patients underwent surgery.To investigate impact factors of management strategy in patients with traumatic splenic rupture,clinical characteristics and CT features between the two groups were compared.Results Univariate analysis results showed that injury causes,blood pressure,at admission,pulse,CT grade and abdominocentesis were closely related with therapeutic scheme.And multivariate Logistic regression analysis results showed that pulse (OR =4.264,95％ CI 1.206-15.073),CT grade (OR =2.086,95％ CI 1.019-4.271) and abdominocentesis (OR =3.428,95％ CI 1.024-11.479) were the significant determining factors of therapeutic scheme in patients with traumatic splenic rupture.Surgical intervention was carried out in 86 patients accounting for 69.4％ of all patients.The rate of surgical intervention was 58.1％ in the patients with CT grade of 1 and 2,that was 94.7％ in patients with CT grade of 3 and 4.Conclusions Operative management is needed for most traumatic splenic rupture,patients those with hemodynamic stability and CT grade of 1 or 2 may be qualified for watchful non-operative management.
