ĐÁNH GIÁ KẾT QUẢ SỚM CỦA PHƯƠNG PHÁP ĐIỀU TRỊ BẢO TỒN VỠ LÁCH TRONG CHẤN THƯƠNG BỤNG KÍN TẠI BỆNH VIỆN NHÂN DÂN 115

Abstract

Objectives: To assess the clinical and subclinical characteristics of patients with splenic rupture in blunt abdominal trauma. To evaluate the early outcomes of NOM for splenic rupture and analyze factors related to hemodynamics, clinical features, and subclinical findings that influence treatment outcomes. Subjects and methods: A descriptive study was conducted on 91 out of 136 patients with splenic rupture due to blunt abdominal trauma treated at People's Hospital 115 between January 2021 and December 2023. Results: A total of 136 patients with splenic rupture due to blunt abdominal trauma were admitted, of which 91 (66.9%) were managed non-operatively. The average age was 37.31 ± 14.88 years, and the male-to-female ratio was 6:1. Traffic accidents were the primary cause of splenic rupture (81.3%). Clinical symptoms included abdominal pain (98.9%) and abdominal distension (27.5%). Ultrasound findings revealed intra-abdominal fluid (92.96%) and parenchymal injury (59.3%). CT scans showed intra-abdominal fluid (97.8%), splenic rupture site (42.9%), parenchymal contusion or hematoma (38.4%), and contrast extravasation (14.3%). Most ruptures were classified as Grade II (30.8%) and Grade III (38.5%). A total of 87.9% of patients responded quickly to initial resuscitation, and 8.8% required blood transfusions. NOM was successful in 88 patients (96.7%), while 3 patients (3.3%) required conversion to splenectomy. The average hospital stay was 5.92 ± 4.83 days. Conclusion: Non-operative management of splenic rupture in blunt abdominal trauma is an effective and safe approach, reducing the need for surgery and postoperative complications.