射頻消融在脾臟外傷后保脾手術中的臨床應用_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

呂濤 ,  蔣曉忠 , 羅洪 , 陶友江

宜賓市第二人民醫院（四川宜賓 644000）;

Corresponding?author：

蔣曉忠, Email: 465963498@qq.com

Keywords：

脾臟外傷; 射頻消融; 保脾手術

DOI：

10.7507/1007-9424.201702069

Video：

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目的探討射頻消融在保脾手術治療脾臟外傷中的臨床應用效果。方法回顧性分析筆者所在醫院科室于 2010 年 7 月至 2015 年 3 月期間行保脾手術治療的 23 例脾臟外傷患者的臨床資料，術中均利用了射頻消融技術。結果 23 例患者均保脾成功，其中 11 例行射頻消融止血修補術，12 例行射頻消融聯合部分脾臟切除術。手術時間為 75～150 min，平均 117 min；術中出血量為 40～500 mL，平均 223 mL；術中見腹腔出血量 800～2 000 mL，平均 1 452 mL，均行自體血回輸；術中見脾臟裂傷程度：Ⅰ 度 10 例，Ⅱ 度 11 例，Ⅲ 度 2 例；拔除引流管時間為術后 2～5 d，平均 2.8 d；術后住院時間為 6～15 d，平均 8.5 d。術后出現發熱 3 例，腹腔再次出血 1 例，血小板計數升高 7 例。術后獲訪 16 例，隨訪時間 8～26 個月，中位數為 11 個月。隨訪期間患者健康情況良好，未見血小板計數異常、脾膿腫等情況。結論射頻消融在保脾手術治療脾臟外傷中的應用是可行的。

Citation： 呂濤, 蔣曉忠, 羅洪, 陶友江. 射頻消融在脾臟外傷后保脾手術中的臨床應用. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(10): 1258-1260. doi: 10.7507/1007-9424.201702069 Copy

1.	Sosada K, Wiewióra M, Piecuch J. Literature review of non-operative management of patients with blunt splenic injury: impact of splenic artery embolization. Wideochir Inne Tech Maloinwazyjne, 2014, 9(3): 309-314.
2.	Rong JJ, Liu D, Liang M, et al. The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis. Mil Med Res, 2017, 4: 17.
3.	中華醫學會外科學分會脾功能與脾臟外科學組. 脾臟損傷治療方式的專家共識(2014版). 中華普通外科學文獻(電子版), 2015, 9(2): 83-85.
4.	Mossadegh S, Midwinter M, Sapsford W, et al. Military treatment of splenic injury in the era of non-operative management. J R Army Med Corps, 2013, 159(2): 110-113.
5.	Huang GS, Chance EA, Hileman BM, et al. Laparoscopic splenectomy in hemodynamically stable blunt trauma. JSLS, 2017, 21(2). e2017.
6.	Walker ML. Nonoperative management of the damaged spleen: a community surgeon looks back. Am Surg, 2017, 83(5): 502-506.
7.	Chavan SS, Tracey KJ. Essential neuroscience in immunology. J Immunol, 2017, 198(9): 3389-3397.
8.	Sinha S, Raja SV, Lewis MH. Recent changes in the management of blunt splenic injury: effect on splenic trauma patients and hospital implications. Ann R Coll Surg Engl, 2008, 90(2): 109-112.
9.	王國梁, 張燕. 外傷性脾破裂術中保脾技術的應用. 中華肝膽外科雜志, 2003, 10(9): 629-630.0.
10.	Pisters PW, Pachter HL. Autologous spleen transplantion for spleen trauma. Ann Surg, 1994, 219(3): 225-235.
11.	陳維佩, 韓殿冰. 脾臟的血管解剖與保脾手術. 中國實用外科雜志, 1999, 19(12): 710-712.0.
12.	Zarzaur BL, Dunn JA, Leininger B, et al. Natural history of splenic vascular abnormalities after blunt injury: A Western Trauma Association multicenter trial. J Trauma Acute Care Surg, 2017, [Epub ahead of print].
13.	陳廣平, 苗金照. 創傷性脾破裂保脾手術中脾動脈結扎分析. 浙江臨床醫學, 2007, 9(10): 1376.0.
14.	Stey AM, Ko CY, Hall BL, et al. Are procedures codes in claims data a reliable indicator of intraoperative splenic injury compared with clinical registry data? J Am Coll Surg, 2014, 219(2): 237-244.
15.	van der Vlies CH, Hoekstra J, Ponsen KJ, et al. Impact of splenic artery embolization on the success rate of nonoperative management for blunt splenic injury. Cardiovasc Intervent Radiol, 2012, 35(1): 76-81.
16.	McIntyre LK, Schiff M, Jurkovich GJ. Failure of nonoperative management of splenic injuries: causes and consequences. Arch Surg, 2005, 140(6): 563-568.
17.	黃志強, 裘法祖. 腹部外科手術學. 長沙: 湖南科學技術出版社, 2001: 662-664.

1. Sosada K, Wiewióra M, Piecuch J. Literature review of non-operative management of patients with blunt splenic injury: impact of splenic artery embolization. Wideochir Inne Tech Maloinwazyjne, 2014, 9(3): 309-314.
2. Rong JJ, Liu D, Liang M, et al. The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis. Mil Med Res, 2017, 4: 17.
3. 中華醫學會外科學分會脾功能與脾臟外科學組. 脾臟損傷治療方式的專家共識(2014版). 中華普通外科學文獻(電子版), 2015, 9(2): 83-85.
4. Mossadegh S, Midwinter M, Sapsford W, et al. Military treatment of splenic injury in the era of non-operative management. J R Army Med Corps, 2013, 159(2): 110-113.
5. Huang GS, Chance EA, Hileman BM, et al. Laparoscopic splenectomy in hemodynamically stable blunt trauma. JSLS, 2017, 21(2). e2017.
6. Walker ML. Nonoperative management of the damaged spleen: a community surgeon looks back. Am Surg, 2017, 83(5): 502-506.
7. Chavan SS, Tracey KJ. Essential neuroscience in immunology. J Immunol, 2017, 198(9): 3389-3397.
8. Sinha S, Raja SV, Lewis MH. Recent changes in the management of blunt splenic injury: effect on splenic trauma patients and hospital implications. Ann R Coll Surg Engl, 2008, 90(2): 109-112.
9. 王國梁, 張燕. 外傷性脾破裂術中保脾技術的應用. 中華肝膽外科雜志, 2003, 10(9): 629-630.0.
10. Pisters PW, Pachter HL. Autologous spleen transplantion for spleen trauma. Ann Surg, 1994, 219(3): 225-235.
11. 陳維佩, 韓殿冰. 脾臟的血管解剖與保脾手術. 中國實用外科雜志, 1999, 19(12): 710-712.0.
12. Zarzaur BL, Dunn JA, Leininger B, et al. Natural history of splenic vascular abnormalities after blunt injury: A Western Trauma Association multicenter trial. J Trauma Acute Care Surg, 2017, [Epub ahead of print].
13. 陳廣平, 苗金照. 創傷性脾破裂保脾手術中脾動脈結扎分析. 浙江臨床醫學, 2007, 9(10): 1376.0.
14. Stey AM, Ko CY, Hall BL, et al. Are procedures codes in claims data a reliable indicator of intraoperative splenic injury compared with clinical registry data? J Am Coll Surg, 2014, 219(2): 237-244.
15. van der Vlies CH, Hoekstra J, Ponsen KJ, et al. Impact of splenic artery embolization on the success rate of nonoperative management for blunt splenic injury. Cardiovasc Intervent Radiol, 2012, 35(1): 76-81.
16. McIntyre LK, Schiff M, Jurkovich GJ. Failure of nonoperative management of splenic injuries: causes and consequences. Arch Surg, 2005, 140(6): 563-568.
17. 黃志強, 裘法祖. 腹部外科手術學. 長沙: 湖南科學技術出版社, 2001: 662-664.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

射頻消融在脾臟外傷后保脾手術中的臨床應用

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