| 摘要 |
Objective: The management of blunt spleen injury in multiple injured patients
was retrospectively reviewed in our institution.
Patients and Methods: One hundred and twenty-one patients with spleen injury
were retrospectively reviewed. Their demographic data, injury severity, diagnostic methods, management, and final outcomes were evaluated.
Results: Fifty patients received non-operative management (Non-op group), 71
received operation immediately (Op group). Nine patients had missed diagnosis of
spleen injury initially. Patients in the Op group had lower blood pressure and
greater amount of blood transfusion in the emergency room, higher injury severity, higher spleen injury grade, more abdominal associated injury, and higher medical cost than patients did in the Non-op group. Seven patients in the Non-op group failed with delayed splenic rupture (7/50; 14%), of whom one died from missed diagnosis of pancreatic injury.
Conclusion: Nonoperative management can be performed successfully in most of
the patients with spleen injury (86%). It is cost effective and can be done safely in multiple injured patients with stable vital signs, lower injury severity and less associated injuries. However, sophisticated clinical evaluation is still needed to avoid tragedy from missed associated injury. |
