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目的探讨食管癌手术中脾脏损伤的预防措施及发生后的临床对策。方法总结分析一组共492例食管癌根治术中发生脾脏损伤共21例患者的临床资料。结果21例患者中Ⅰ度损伤12例,Ⅱ度损伤7例,Ⅲ度损伤2例;行各种方式的脾脏修补术17例,无法保留脾脏行脾切除者4例;术后发生脾窝感染1例,血小板增高给予抗凝治疗1例;所有患者无术后腹腔出血,均痊愈出院。结论食管癌手术中需防止脾脏的损伤,一旦发生需采取合理的措施防止损伤扩大,尽量避免脾脏切除,以利于术后恢复。
Objective To investigate the preventive measures of spleen injury in esophageal cancer surgery and the clinical strategies after it. Methods A total of 492 cases of esophageal cancer who had undergone splenectomy were included in the study. The clinical data of 21 patients were analyzed. Results Among the 21 patients, there were 12 cases of degree Ⅰ injury, 7 cases of degree Ⅱ injury and 2 cases of grade Ⅲ injury. There were 17 cases of spleen repair in various ways, 4 cases of splenectomy were not retained in spleen, 1 case, thrombocytopenia given anticoagulant therapy in 1 case; all patients without intraperitoneal hemorrhage, were cured and discharged. Conclusion Esophageal cancer surgery to prevent the injury of the spleen, in the event of need to take reasonable measures to prevent injury to expand, try to avoid splenectomy, in order to facilitate postoperative recovery.