Objective To analyze comparatively the curative effect of orthotopic and extruded splenectomy. Methods 62 patients with splenectomy for January 2009 to January 2012 in our hospital were selected, of which 32 patients with orthotopic splenectomy were selected as the group A, and 30 patients with extruded splenectomy were selected as the group B. The intraoperative bleeding, postoperative drainage, time to get out of bed, operation time and postoperative hospitalization time of patients in the two groups were observed and compared, and the incidence of complications such as splenic fossa abscess, splenic fever, infections (urinary tract infections, lung infections), pancreatic fistula of patients in the two groups were compared and analyzed by the application of statistics method. Results The intraoperative bleeding, postoperative drainage, time to get out of bed and operation time of patients in the group B were significantly shorter than those in the group A, the differences were statistically significant between two groups(P<0.05). The difference was not statistically significant in the postoperative hospitalization time between the group B and group A(P > 0.05).No a case of splenic fossa abscess happened in the group B, the incidence of splenic fever, infection, pancreatic fistula complications in the group B was 13.3%, although which was lower than in the group A(15.6%), but there was not significant difference between two groups(P>0.05). Conclusion The curative effect of extruded splenectomy is significantly better than that of orthotopic splenectomy, extruded splenectomy has the advantages with the quick operation, short operative time, quick recover and fewer complications, and is worthy of extensive promotion and application, but demands to grasp strictly the indications of operation.%目的：对比分析原位脾切除术与托出式脾切除术的疗效。方法入选的62例脾切除患者为2009年1月~2012年1月在我院进行手术治疗的患者，其中行原位脾切除术治疗的患者32例设立为A组，行托出式脾切除术治疗的患者30例设立为B组，观察比较两组患者术中出血量、术后引流量、下床活动时间、手术时间及术后住院时间等手术指标，以及应用统计学方法对两组患者出现脾窝脓肿、脾热、感染（泌尿系感染、肺部感染）、胰瘘等并发症发生率进行比较分析。结果 B组患者的术中出血量、术后引流量、下床活动时间、手术时间均明显短于A组，组间比较差异均有统计学意义（P＜0.05）。B组术后住院时间与A组比较，差异无统计学意义（P＞0.05）。B组患者无一例发生脾窝脓肿，发生脾热、感染、胰瘘等并发症发生率合计13.3%，虽然低于A组并发症的发生率（15.6%），但组间比较差异无统计学意义（P＞0.05）。结论托出式脾切除术的疗效明显优于原位脾切除术，具有操作迅速、手术时间短、患者恢复快等优点，且并发症少，值得广泛推广和应用，但要求严格掌握好手术适应证。
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