丁卫星 528000 佛山，广东省佛山市第一人民医院胃肠外科 中国胃肠外科杂志 1999 0 2 2


    关键词：胃切除；医源性脾损伤；处理 期刊 zgwcwkzz 0 论著 fur -->


    

【摘要 】 目的 为进一步在胃手术中注意保护健康的脾脏。方法 回顾性分析本院8年来在胃切除术中出现15例医源性脾损伤的临床资料。结果 15例脾损伤中溃疡病胃切除术6例，胃癌根治术8例，贲门癌根治术1例，占同期胃切除术3.3%(15/457例)。按Pachter脾损伤分级，Ⅰ级12例，Ⅱ级2例，Ⅲ级1例。致伤原因是术者人为造成。4例经电凝加医用生物蛋白胶止血，5例行大网膜逢合、明胶海绵压迫止血，3例行逢合修补术，3例全脾切除。全组均痊愈出院，3例脾切除患者中2例术后并发感染。结论 胃手术导致脾脏损伤是一种医源性的脾损伤。这种损伤是可以预防或降到最低限度的，及时发现正确处理十分重要。

The management of complicative splenic trauma during gastrectomy： A review of 15 cases

DING Weixing.

    Department of Gastrointestinal Surgery, First People′s Hospital of Foshan, Guangdong Foshan 528000

【Abstract 】 Objective To protect normal spleen during gastrectomy. Methods 15 cases with iatrogenic spleen injury during gastrectomy from 1991 to 1999 in our hospital were analyzed retrospectively. Results Among them, spleen injury occurred during gastrectomy for peptic ulcer in 6 cases, during radical gastrectomy for gastric cancer in 8 cases and during cardiac carcinoma in 1 case. The incidence was 3.3%(15/457). On Pachter grading of splenic injury, 12 cases were gradeⅠ,2 were Ⅱ, one was Ⅲ. All of them were caused by operators. Four were managed by electrocautery and FG, five by gelatin and omentum covering, three by apposition suture and other three by splenectomy. Conclusion Spleen injury during gastrectomy is a kind of iatrogenic splenic trauma which can be prevented or decreased to the lowest. It is very important that the trauma is discovered in time and managed properly.

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