부산대학교 도서관

[Introduction] The use of non-operative management (NOM) to treat splenic injuries has been expanding in recent years. We investigated the validity and limits of NOM as a treatment for such injuries in patients with unstable hemodynamics. [Materials and Methods] We registered 18 cases of splenic injury and categorized the cases into two groups : the shock and non-shock groups. The frequencies of massive transfusions (MT), aortic blockage, and interventional radiology (IVR) were compared between the two groups. [Results] There were 10 and 8 patients in the shock and non-shock groups, respectively. We observed that MT (p<0.01) and IVR (p=0.04) were significantly more common in the shock group than in the non-shock group. The frequency of aortic blockage was 30% (3/10) in the shock group. In the shock group, the selection rate and success rate of NOM were 80% (8/10) and 88% (7/8), respectively. The hemodynamics of the patients in whom NOM was successful were improved by damage control resuscitation (DCR) ; however, in the cases in which NOM was unsuccessful, DCR did not improve the patients' hemodynamics due to the presence of abdominal compartment syndrome. [Conclusion] The NOM of splenic injuries was successful in a high percentage of patients with unstable hemodynamics. In cases of splenic injury, if the patient's hemodynamics are not improved by DCR surgery should be performed immediately.