[1]陈璐璐,赵俊刚,黄顺根,等. 苏州市165例儿童脾外伤的流行病学特征及治疗选择的影响因素分析[J].临床小儿外科杂志,2018,17(11):840-844.
　Chen Lulu,Zhao Jungang,Huang Shungen,et al. Clinical analysis of 165 cases of splenic trauma in children in Suzhou.[J].Journal of Clinical Pediatric Surgery,2018,17(11):840-844.
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 苏州市165例儿童脾外伤的流行病学特征及治疗选择的影响因素分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年11期 页码: 840-844 栏目: 论著 出版日期: 2018-11-20
Title:
 Clinical analysis of 165 cases of splenic trauma in children in Suzhou.
作者:
 陈璐璐; 赵俊刚; 黄顺根; 等.
 苏州大学附属儿童医院外科
Author(s):
 Chen Lulu; Zhao Jungang; Huang Shungen; Wang Jian.
 Department of General Surgery,Affiliated Childrens Hospital,Suzhou University,Suzhou 215000,China.
关键词:
 ; 脾外伤;  腹部损伤;  流行病学;  治疗;  儿童
Keywords:
 ; Spleen Trauma;  Abdominal Injuries;  Epidemiology;  Therapy;  Child
文献标志码:
A
摘要:
 目的初步分析苏州市165例脾外伤儿童的年龄分布、外伤原因及合并损伤情况，并探讨治疗方式选择的影响因素。方法以2011年1月至2017年12月苏州大学附属儿童医院收治的165例脾外伤患儿为研究对象，其中155例（93.9%）采取非手术治疗，10例（6.1%）采取手术治疗，对其临床资料进行回顾性研究。采用二元Logistic回归对治疗方式选择的影响因素进行分析。结果165例儿童脾外伤中，学龄前期（3~6岁）儿童占比最多（40%）；外伤原因以意外摔伤或撞伤（65人，39%）、交通事故（80人，48.5%）为主；76例（46.1%）为单纯脾挫裂伤，89例（53.9%）合并其它损伤（包括肺脏外伤、骨折、肝挫伤、泌尿系损伤等）。超声、CT平扫和增强CT对本病的诊断正确率分别为68.3%、81.9%和98.6%。非手术治疗组和手术治疗组在收缩压、入院血色素以及有输血史人数的构成比上存在统计学差异（P<0.05），Logistic回归分析结果显示，患者是否接受输血是治疗方式选择的影响因素（OR=12.255，95%CI:1.410~106.531）。结论脾外伤以学龄前期和学龄期儿童多见；增强CT在诊断外伤及合并损伤中具有较为优质的临床价值；非手术治疗是儿童脾外伤的主要治疗方式；有输血史的患儿有更大概率接受手术治疗。
Abstract:
 ObjectiveTo improve the understanding of splenic trauma in children by analyzing age distribution,causes of trauma,methods of detection,combined injuries and treatments of splenic trauma in Suzhou.MethodsThe clinical data were collected and retrospectively analyzed for 165 hospitalized children with splenic trauma from January 2011 to December 2017.ResultsThe major causes of injuries included accidental falls & bruises (n=65,39%),traffic accidents (n=80,48.5%) and dropping from a high place (n=18,11%).Significant intergroup differences existed in systolic blood pressure,admission level of hemoglobin and presence or absence of transfusion (P<0.05).The ultrasonic diagnostic rate was 68.3%,CT scan 81.9% and enhanced CT 98.6%.There were simple splenic trauma (46.1%) and other injuries (53.9%),including lung trauma,bone fracture,liver contusion and urinary system injury,etc.Among them,155 children (93.9%) received conservative treatment and 10 children (6.1%) were operated.Seven of them underwent open splenic resection and treatments of the remainder included laparoscopic abdominal exploration plus splenectomy and splenic rupture repair.As compared with those without blood transfusion,there was a significant increase in surgical risk for transfusions（OR=12.255,95%CI:1.410~106.531).ConclusionAge distribution of children with splenic trauma is predominant at preschool and school ages.Accidental falls or bruises,dropping from a high place and traffic accidents are the major causes of splenic trauma in children.Children with splenic trauma often have combined injures of two or more other organs.Enhanced CT can effectively diagnose splenic trauma and combined injuries.Most cases of splenic trauma may be treated conservatively and blood transfusion is an independent surgical risk factor.

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更新日期/Last Update: 2018-11-23