二级脾蒂精准离断腹腔镜脾切除术治疗创伤性脾破裂的效果

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[Abstract]Objective： To investigate the clinical efect and safety of laparoscopic splenectomy with precise secondary splenic pedicle disection in the treatment of traumatic splenic rupture （TSR）. Method： Eighty patients with TSR who were admited to Xinyu People's Hospitalfrom January 2O23 to November 2O24 were selected as the study subjects. They were divided into the reference group （traditional laparoscopic splenectomy， n =39） and the study group （laparoscopic splenectomy with precise secondary splenic pedicle dissection， n=41 ）according to the surgical method.The two groups were compared onclinical eficacy，surgery-related indicators，blood indexes， immune function，and the incidence of postoperative complications.Result：The total response rate in the study group was 97.56% （40/41），which was higher than 69.23% （27/39） in the reference group，the difference was statisticallysignificant（ P <0.05）.The time for splenic artery ligation，length of hospital stay，postoperative first exhaust time and first feedingtime in the study group were beter thanthose in thereference group，the intraoperative blood losin the study group was lower than that in the reference group，with statistically significant diffrences （ P <0.05）.The drainage volume and changes in Hband albumin in the study group were smalerthan those in the reference group，the differenceswere statistically significant （ P <0.05）. One month after surgery，the levels of IgG， IgA and IgM were decreased inboth groups compared to preoperative levels，and the levels in study group were lower than those in the reference group，with statistically significant differences （ P <0.05）. The total incidence of complications in the study group was 4.88 % （2/41）， compared with 7.69 % （3/39） in the reference group，there was no statistically significant difference （ P >0.05）.Conclusion：Laparoscopic splenectomy with precise secondary splenic pedicle dissection is efectiveforTSR.Itcanshortenthe timeofsplenicarteryligation，thetimeof hospitalstay，first postoperative exhaust and first meal intake，reduce intraoperative blood lossand drainage volume，the changes in Hb and albumin，enhance the immune function of patients，and has relatively high safety.

[Keywords]LaparoscopySecondary splenic pedicle dissection Traumatic splenic ruptureSplenectomy First-author'saddress：TraumaEmergencyCenter，XinyuPeople'sHospital，Xinyu338ooo，China doi： 10.3969/j.issn.1674-4985.2025.22.001

创伤性脾破裂（TSR）多由车祸、高处坠落、暴力撞击等外伤所致，流行病学调查显示，TSR患者占比高达 30% ，易诱发腹腔内大出血，增大死亡风险[-2]。（剩余5719字）