钝性腹部创伤脾损伤的处理-一项横断面研究

Rishabh Goel
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摘要

背景:脾脏是钝性创伤后最常见的实体器官。机动车碰撞伤占脾损伤的75%以上。在多达60%的患者中,脾脏是唯一受损的器官,死亡率约为8.5%。一些研究指出,半数以上的钝性脾损伤可以通过非手术治疗,其发病率与手术治疗相似或低于手术治疗。钝性脾外伤的治疗因此转向非手术治疗。目的:探讨钝性腹部外伤后脾损伤的处理方法。材料和方法:从2020年11月1日至2021年10月31日在巴雷利罗希尔坎德医学院和医院外科进行了一项横断面研究。36例脾外伤患者纳入研究。结果:1、2级脾损伤全部保守处理,10例3级脾损伤7例保守处理。3例III级脾损伤患者行手术干预,其中1例行脾切除术,2例行脾修补术。IV级脾损伤7例中6例行手术治疗,5例行脾切除术,1例行脾修补术。所有V级损伤患者均行脾切除术。结论:在我们的研究中,I级和II级脾损伤患者以及大多数III级脾损伤患者(52.5%)可以保守治疗。
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Management of Splenic Injury in Blunt Abdominal Trauma- A Cross-Sectional Study
Background: Spleen is the most commonly injured solid organ following blunt trauma. Motor vehicle collision account for more than 75% of splenic injuries. In up to 60% of patients, the spleen is the only organ injured, with mortality rates of roughly 8.5%. Some studies quote that more than half of blunt splenic injuries can be managed by non-operative management with morbidity similar to or less than that of operative management. The management of blunt splenic trauma has therefore shifted towards non operative management. Objective: To study the management of splenic injury in blunt abdominal trauma. Material and Methods: A Cross-sectional study was conducted in the department of Surgery, Rohilkhand Medical College and Hospital, Bareilly from 1st November 2020 to 31st October 2021. 36 patients of splenic trauma were included in the study. Result: All grade I and II and 7 out of 10 grade III splenic injuries were managed conservatively. Three patients with grade III splenic damage underwent surgical intervention, with one undergoing splenectomy and two undergoing splenorrhaphy. In Grade IV splenic damage, 6 out of 7 patients were managed operatively, splenectomies were performed in 5 patients and splenorrhaphy was performed in 1 patient. All patients with grade V injuries underwent a splenectomy. Conclusion: In our study, patients with Grade I and Grade II splenic trauma and the majority of Grade III trauma a total of 52.5% of patients could be managed conservatively.
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