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首页> 外文期刊>The Egyptian Journal of Hospital Medicine >Conservative Versus Operative Management of Blunt Splenic Injuries
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Conservative Versus Operative Management of Blunt Splenic Injuries

机译：保守与手术治疗钝性脾损伤

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Background: The spleen is the most frequently injured organ in blunt abdominal trauma, mainly because of its highly vascularized parenchyma and its anatomic location . In the past the management of blunt splenic injuries was splenectomy, but high rate of operative complications caused paradigm shift from operative to non-operative management (NOM) in hemodynamically stable blunt abdominal trauma patients . Now, nonoperative management of hemodynamically stable patients with blunt splenic injuries is the standard of care and has been proven to be safe and successful in the acute setting . The advent of newer imaging techniques with high resolution CT scanners has enabled the clinicians to exactly diagnose the extent of intra-abdominal organ injury. Objective: This work aim to compare between operative and conservative management of splenic trauma. Methodology: Total numbers of patients in this study were 20 patients classified in two groups, the first group contained12 patients and the other group contained 8 patients. The First group was managed conservative and the second was managed operative with splenectomy and splenoraphy. The first group of patients consisted of 9 males (75%) and 3 female (25%). The second group of patients consisted of 6 males (75%) and 2 females (25%). Results: In this study, bunt splenic injury was found to be more common in males because of their risky and hard work. RTA and Falling from a height were found to be the most common causes of blunt abdominal injuries. According to CT, grade one and two of splenic injury are more common than other grades of splenic injury. As regard complication the operative management has more complication as postoperative wound infection and postoperative chest infection. So, NOM of splenic injury is the management of choice in haemodynamically stable patients. Conclusion: The nonoperative management is considered the ideal management for blunt splenic injuries due to less complication, less blood transfusion, less hospital stay and less mortality than operative management.
机译：背景：脾脏是腹部钝器中受伤最频繁的器官，主要是由于其实质性血管高度血管化及其解剖位置。过去，脾脏钝性损伤的治疗是脾切除术，但是高手术并发症率导致血液动力学稳定的钝性腹部外伤患者从手术模式转变为非手术模式（NOM）。现在，对血液动力学稳定的钝性脾损伤患者进行非手术治疗已成为治疗的标准，并已被证明在急性环境中是安全且成功的。高分辨率CT扫描仪更新的成像技术的出现使临床医生能够准确地诊断腹腔内器官损伤的程度。目的：本工作旨在比较脾外伤的手术和保守治疗。方法：本研究的患者总数为20位患者，分为两组，第一组包含12位患者，另一组包含8位患者。第一组采用保守治疗，第二组采用脾切除术和脾镜治疗。第一组患者包括9例男性（75％）和3例女性（25％）。第二组患者包括6例男性（75％）和2例女性（25％）。结果：在这项研究中，由于男性的高风险和艰苦的工作，使小腿脾脏损伤更为常见。发现RTA和从高处掉下是造成钝性腹部受伤的最常见原因。根据CT，脾脏损伤的一级和二级比其他级别的脾脏损伤更常见。关于并发症，手术管理方面有更多的并发症，如术后伤口感染和术后胸部感染。因此，脾脏损伤的NOM是血流动力学稳定患者的首选治疗方法。结论：非手术治疗被认为是钝性脾损伤的理想治疗方法，因为与手术治疗相比，并发症少，输血少，住院时间少和死亡率低。

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