目的 分析研究二级脾蒂离断术在外伤性脾破裂脾切除术中的临床疗效.方法 选自我院2008年10月至2011年10月收治的102例外伤性脾破裂患者.将所有患者随机地分为研究组(二级脾蒂离断术组)和对照组(传统脾蒂离断术组)各51例.比较两组患者的手术时间、术中出血量及术后并发症的情况.结果 对照组患者的手术时间为(52.18±0.24) min,术中出血量为(137.48±10.74) ml；研究组患者的手术时间为(56.47±1.21) min,术中出血量为(144.74±11.03) ml,且两组比较差异无统计学意义(t=4.31、3.82,P＞0.05).研究组术后来出现并发症；对照组患者术后有2例出现脾蒂继发性出血,4例出现胰瘘,8例出现脾热,术后并发症的发生率为27.45％.两组患者的术后并发症发生率比较差异有统计学意义(x2=16.23,P＜0.05).结论 二级脾蒂离断术与传统的脾蒂离断术比较,手术时间与术中出血量差异无统计学意义,术后并发症发生率低,临床疗效确切,值得在临床推广.%Objective To evaluate the application of secondary spleen pedicle disconnection in the resection of traumatic splenic rupture. Methods One hundred and two patients of traumatic splenic rupture admitted in our hospital from October 2008 to October 2011 were randomly divided into two groups: the study group (n=51, treated with secondary spleen pedicle disconnection) and the control group (n=51, treated with traditional spleen pedicle disconnection). The operation duration, intraoperatve blood loss, and the postoperative complications were compared between the two groups. Results The operation duration and intraoperatve blood loss in the study group was (56.47?1.21) min and (144.74?1.03) ml, respectively, showing no statistically significant difference with those in the control group [(52.18?.24) min and (137.48?0.74) ml, respectively], with P>0.05. No case of complications was found in the study group, while two cases of splenic pedicle hemorrhage, 4 cases of pancreatic fistula and 8 cases of splenic fever were found in the control group (with a incidence of complications of 27.45%). The postoperative complications showed statistically significant difference between the two groups, with P<0.05. Conclusion In the resection of traumatic splenic rupture, secondary spleen pedicle disconnection has lower incidence of postoperative complications, compared with traditional spleen pedicle disconnection, which is worthy to be extended in clinical practice.
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