Comparison of curative effect between two operation methods on treatment of the simple third-fourth grade of traumatic spleen rupture in patients with shock
10.3760/cma.j.issn.1671-0282.2018.06.021
- VernacularTitle:两种手术方式治疗Ⅲ、Ⅳ级创伤性脾破裂伴休克的疗效比较
- Author:
Tao ZHAO
1
;
Qiuxing CHEN
;
Gaosheng WANG
;
Leilei GAN
;
Xin YU
Author Information
1. 中国科技大学附属第一医院急诊外科
- Keywords:
Traumatic spleen rupture;
Shock;
Selective splenic artery embolization
- From:
Chinese Journal of Emergency Medicine
2018;27(6):679-682
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the therapeutic regimen for the simple third or fourth grade of traumatic spleen rupture in patients with hemorrhagic shock. Methods A total of 58 patients with traumatic spleen rupture complicated with hemorrhagic shock admitted between January 2012 and June 2016 were enrolled for analysis. The causes of the casualties suffering from closed abdominal injuries including 31 traffic accident, 13 falling down from a height, 8 tumbling on the ground, 2 beaten trauma and 4 other traumatic injuries. All the patients were divided into the conventional surgery group or proximal selective spleen artery embolization (PASE) group. Comparisons of surgery and postoperative relevant parameters between two groups were analyzed, and the curative effects of the two kinds of treatments was evaluated. Results There were no statistically significant difference in age, sex, degree of spleen rupture, systolic blood pressure, heart rate, and hemoglobin concentration between two groups (P＞ 0.05). The time consumed for operation (T1),the time required for systolic blood pressure recovery (T2), and the allogeneic blood volume capacity (V2) transfused in PASE group were significantly lesser than those in the conventional surgery group (P＜0.05), however there was no difference in the autologous blood volume reinfusion (V1) (P＞ 0.05). Furthermore, the incidence of fever, infection of incision, ileus, ICU treatment, time required fro intestinal function time and hospital stay in PASE group were significantly lesser than those in conventional surgery group (P＜0.05), but the incidence of left upper abdominal pain in PASE group was higher (P＜0.05). Conclusions Selective spleen artery embolization can rapidly stabilize hemodynamics, and shorten the operation time. It also can reduce the complications and allogeneic blood use, shorten recovery time and hospital stay. It is a preferential choice for treatment of traumatic spleen rupture with shock, and worth popularizing in clinical.
