Clinical analysis on comparison of outcomes between partial splenic artery embolization and splenectomy for management of grade II-III splenic injury in blunt trauma

钝性创伤导致的II-III级脾损伤治疗中,部分脾动脉栓塞术与脾切除术疗效比较的临床分析

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Abstract

BACKGROUND: The spleen is also the largest lymphoid organ and has important immune and haematopoietic functions. Traumatic splenic rupture often results in haemorrhagic shock and is life-threatening. In the past, total splenectomy was performed for various degrees of splenic injury, which caused great harm to the patient. Over the past few decades, the treatment of blunt splenic injury has also changed significantly, from total splenectomy to a focus on procedures that preserve splenic function. At the same time, the use of splenic artery embolization in high-grade splenic injuries has also reduced the failure rate of non-surgical treatment and the incidence of conversion to open splenectomy. METHODS: According to the American Association for the Surgery of Trauma (AAST) spleen injury grading, this study selected 80 patients treated in our emergency department for blunt splenic injuries of grade II-III between 1 January 2023 and 1 January 2025. These patients were the study subjects (40 patients received partial splenic artery embolization (intervention group) and 40 patients received splenectomy (control group)). The clinical therapeutic outcomes of the two treatment approaches were analysed by SPSS. RESULTS: In contrast to the control group, patients in the intervention group exhibited reduced operation time, time to first flatus, time to removal of drainage tubes and hospitalization time. Furthermore, the incidence of surgical complications was found to be lower in the intervention group than in the control group. The T lymphocyte CD4 + /CD8 values of the intervention group were higher than those in the control group at 2 and 4 weeks postoperatively, and the difference was statistically significant (P < 0.05). CONCLUSION: Partial splenic artery embolization has obvious advantages in the treatment of grade II-III blunt splenic injuries, and provides data support and reference significance for the selection of treatment methods for low-grade blunt splenic injuries. TRIAL REGISTRATION: This study is a statistical analysis of relevant data for patients who have received a medical intervention and therefore does not involve trial registration.

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