NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC TRAUMA - A 10-YEAR EXPERIENCE

被引：39

作者：

KOURY, HI ^{[1
]}

PESCHIERA, JL ^{[1
]}

WELLING, RE ^{[1
]}

机构：

[1] GOOD SAMARITAN HOSP,DEPT SURG,TRAUMA SERV,3217 CLIFTON AVE,CINCINNATI,OH 45220

来源：

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 1991年 / 22卷 / 05期

关键词：

D O I：

10.1016/0020-1383(91)90091-R

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

There is growing awareness that the majority of traumatic splenic injuries should be managed non-operatively. This review of all traumatic spleen injuries at a large community teaching hospital over a 10-year period (1978-1988) confirms that principle. The study generated selection criteria and principles of non-operative management. Of a total of 91 patients, 23 were initially treated non-operatively. The average age was 27 years and all but two were adults. Splenic injury was confirmed by computed tomography scan in 20 patients (87 per cent) and by liver/spleen scan in three patients (13 per cent). Of the 23 patients, 21 (91 per cent) were successfully treated non-operatively. Of these, 14 had intraparenchymal or subcapsular haematomas and seven had splenic lacerations with haemoperitoneum. Two patients (9 per cent) initially treated non-operatively required splenectomy. Haemodynamically stable adult patients with blunt splenic injuries can be managed non-operatively if monitored in a setting where immediate operative intervention is available. Operative intervention is indicated not only in haemodynamically unstable patients, but also in patients who require more than four units of blood during a 48-h period.

引用

页码：349 / 352

页数：4

共 30 条

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