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외상성 비장 손상 환자의 치료방법의 선택: 단일 기관 연구
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  • 외상성 비장 손상 환자의 치료방법의 선택: 단일 기관 연구
  • The Choice of Management in Patients with Splenic Blunt Trauma : A Single Center Study
저자명
장지영,이승환,이재길,Jang. Ji Young,Lee. Seung Hwan,Lee. Jae Gil
간행물명
大韓外傷學會誌
권/호정보
2013년|26권 4호|pp.280-285 (6 pages)
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
서지반출

기타언어초록

Purpose: Nowadays, non-operative management increases in patients with blunt splenic injury due to development of diagnostic and interventional technique. The purpose of this study is to evaluate the management in patients with blunt splenic injury and effect of clinical state such as shock on the choice of management. Methods: From April 2007 to July 2013, we retrospectively reviewed the medical charts of fifty patients who had splenic injury after blunt trauma. The demographic characteristics, American Association for the Surgery of Trauma (AAST) grade of splenic injury, management method (emergency operation, angiographic embolization or observation) and clinical outcome were analyzed. Results: The mean age was $41.5{pm}21.4$ years and male was 44(88%). Twenty patients(40%) were in shock condition initially and five patients(10%) underwent emergency operation due to hemodynamic instability. Emergency angiographic embolization was performed in 20 patients(40%) and 25 patients were managed conservatively. When patients were divided into shock group (SG) and non-shock group (NSG), Patients in SG had significantly higher serum lactate level and base deficit than NSG (lactate; $4.5{pm}3.4$ mmol/L, base deficit; $5.8{pm}4.4$ mmol/L vs $1.9{pm}1.4$ mmol/L, $2.8{pm}2.5$ mmol/L, p=0.007, p=0.013). There was no significant difference of AAST grade and contrast blush rate in abdomen CT between two groups. Among 45 patients with non-operative management, four patients(8.9%) got delayed angiographic embolization and 3 patient died from companied organ injury. Conclusion: Non-operative management can be acceptable management option in patients with splenic blunt trauma under intensive hemodynamic monitoring.