تدبير أذيات الطحال في رضوح البطن الكليلة عند البالغين
Abstract
شملت هذه الدراسة 32 مريضا ً قبلوا في قسم الجراحة في مشفى الأسد الجامعي باللاذقية في الفترة بين1/7/2002 حتـّى 1/7/2009، 8 إناث (25%) و24 ذكراً (75%). حيث تمّ تقييم مرضى الرضوح الكليلة على البطن وانتقاء المرضى الذين كان الشكّ عندهم بوجود أذيّة طحالية تمّ تأكيدها بالتصوير الصدوي (الإيكو) أو الطبقي المحوري.
تـمّ تقسيم المرضى إلى مجموعتين تبعـاً للإجراء العلاجي المتّبع, حيـث خضع مرضى المجموعـة الأولى (21 مريضاً) لعمل جراحي إسعافي أمّـا المجموعة الثانية (11 مريضاً) فقد تمّت مراقبتهم فـي قسم الجراحة, وذلك بتعويض السوائل ونقـل الدمّ إذا لـزم الأمر. فشـل العلاج المحافظ (غير الجراحي) فـي
3 حالات خلال 72 ساعة (حالتين كانتا خلال 24 ساعة الأولى وحالة واحدة بعد 72 ساعة).
كان هدف الدراسة إيضاح السبيل الأفضل لمقاربة مريض رضح الطحال الكليل ومزايا كلّ من العلاج الجراحي والعلاج المحافظ (غير الجراحي).
The objective of this study was to demonstrate the best way to approach the patients with blunt spleen traumas and show the benefits of surgical and non-surgical management. This study included 32 patients (8 females (25%) and 24 males (75%) admitted to the Department of Surgery at Al-Assad University Hospital in Lattakia between 1/7/2002 and 1/7/2009. We examined patients with blunt abdominal traumas; then we chose the ones with a history related to spleen injury; this was confirmed either by computerized tomography (CT) or by echography. Patients were divided into two groups according to the way they were treated. Patients in the first group (21 patients) had an emergency operation. Patients in the second group (11 patients) were monitored in the Department of Surgery and had, if necessary, fluid administration and blood transfusion. The non-operative management failed in 3 cases within 72 hours (2 cases within the first 24 hours, and one case after 72 hours).
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