闭合性脾破裂39例非手术治疗体会

目的　总结闭合性脾破裂的非手术治疗经验。方法　对 1990～ 2 0 0 0年 12月采用非手术治疗的 39例脾破裂的临床资料进行回顾性分析。结果　 39例均痊愈出院。其中非手术治疗成功33例 (84 .8% ) ,住院时间 8～ 2 2d ,平均 15d。余 6例因在非手术治疗期间出现血液动力学不稳或延迟性出血而中转手术治愈。结论　在严格掌握适应证和密切动态观察伤情变化的条件下 ,非手术治疗脾破裂是安全可行的 ,对非手术治疗期间血液动力学不稳定或发生延迟性出血者应及时手术

Experience of nonoperative management for 39 cases of closed spleen rupture

Objective To summarize the experience of nonoperative management of closed spleen rupture.Methods The clinical data of nonoperation for 39 cases of closed spleen rupture from 1990 to Dec. 2000 was retrospectively analyzed.Results Thirty nine cases were all cured. Among them, 33 cases ( 84.8% ) were cured by nonoperative management with the average hospitalized stay of 15 dats (ranging from 8 to22 days), 6 by operation after the failure of nonoperative management due to the occurrence of unstable hemodynamics of delayed hemorrhage during the period of nonoperative management.Conclusions The nonoperative management of closed spleen rupture was safe and available when indication was strictly controlled and change of injury condition was constantly observed. The operation should be promptly performed when the patient's hemodynamics was unstable or delayed hemorrhage occurred during the period of nonoperative management.