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目的:探讨胃癌根治术中医源性脾损伤的原因和处理方法。方法:回顾性分析2001年1月至2013年12月普外科医源性脾损伤的临床资料。结果:在4652例胃癌根治术中发生医源性脾损伤30例,脾损伤率4.6%。脾损伤按Pachter分级,I级6例、Ⅱ级15例、Ⅲ级4例。保脾成功25例,全脾切除3例。全组均痊愈出院。结论:胃癌根治术中医源性脾损伤的发生是常见并发症。良好的麻醉和细致的手术操作可以有效预防和减少医源性脾损伤的发生。
Objective: To investigate the causes and treatment of splenic injury in patients with gastric cancer undergoing radical operation. Methods: The clinical data of primary surgical splenic injuries from January 2001 to December 2013 were retrospectively analyzed. Results: In 4652 cases of radical gastrectomy, iatrogenic splenic injury occurred in 30 cases and splenic injury rate was 4.6%. Spleen injury by Pachter grading, I grade in 6 cases, Ⅱ grade in 15 cases, Ⅲ grade in 4 cases. 25 cases of successful spleen maintenance, splenectomy in 3 cases. The whole group were discharged. Conclusion: The incidence of Chinese-made spleen injury after radical gastrectomy is a common complication. Good anesthesia and careful surgical operation can effectively prevent and reduce the occurrence of iatrogenic splenic injury.