超声造影引导迟发性脾破裂的诊治实验研究
|
摘要
目的①在超声造影引导下建立迟发性脾破裂动物模型；②探讨超声造影引导下局部注射止血剂治疗迟发性脾破裂的应用价值；③超声造影引导下可注射性明胶基止血剂治疗脾脏外伤止血效果的动物实验研究。
材料和方法①15只健康杂种犬常规麻醉，开腹制作脾脏血肿，72小时后以小型撞击器撞击实验犬腹壁造成血肿破裂，血肿破裂后前后均行常规超声、超声造影及增强CT检查。观察血肿破裂前后常规超声、超声造影表现，探讨其结果与增强CT的对照研究；②14只健康杂种犬常规麻醉，开腹制作迟发性脾破裂动物模型在超声造影引导下先后多点注射蛇毒凝血酶2ml和α-氰基丙烯酸酯1mL，分别在术后、第1天、第3天、第7天、第14天及第21天行常规超声和超声造影检查，观察脾脏损伤区域面积和腹腔积液情况，脾切除术后行病理学检查；③24只健康杂种犬常规麻醉，开腹后暴露脾脏，用止血钳在脾脏膈面制作长、宽、深分别为4cm、4cm、2.5cm的脾脏实质锐器伤。实验犬随机分为两组，治疗组在超声造影引导下注射4ml HIGM，阳性对照组注射4ml蛇毒凝血酶和α-氰基丙烯酸酯对创伤灶行局部注射治疗，通过超声造影观察即刻疗效，并在第1天、第3天、第7天、第14天及第21天行常规超声及超声造影分别观察记录腹腔积液和创伤灶面积，并于第21天行脾切除术，通过大体标本观察脾脏愈合情况并行组织病理学检查。
结果①4只实验犬脾脏血肿面积明显缩小，72小时后血肿消失。11只实验犬脾脏血肿形成，常规超声对血肿边界显示不清晰，而超声造影可清晰显示血肿边界，大小，并观测到72小时后血肿面积明显增大。小型撞击器击打腹壁后，常规超声对创伤灶显示不清，可清晰显示腹腔积液，超声造影可清晰显示血肿破裂，部分血肿可见活动性出血。增强CT证实超声造影检查结果。②治疗组实验犬均存活。脾脏创伤灶经蛇毒凝血酶和α-氰基丙烯酸酯联合注射后，超声造影显示活动性出血消失，局部注射α-氰基丙烯酸酯处呈强回声。治疗后4个时间点观察，超声造影显示血肿面积明显缩小并未见活动性出血，常规超声显示腹腔积液减少。剖腹探查见大体标本显示创伤灶完全愈合，局部可见大网膜贴附，未见明确的并发症发生。③治疗组及阳性对照组所有实验犬均存活。治疗组在超声造影引导下注射HIGM后，损伤区域未见活动性出血，第1、3、7天创伤灶面积逐渐缩小，第14、21天所有实验犬（n=12）均未见创伤灶回声，阳性对照组实验犬于第1、3、7、14天可见创伤灶回声，第21天所有实验犬（n=12）未见创伤灶回声，且在第1、3、7天两组间创伤灶面积有显著统计学差异（p<0.05）。常规超声显示第3、7、14、21天治疗组未见腹腔积液，阳性对照组第14、21天未见腹腔积液，在第1、3、7天两组间腹腔积液测量值有明显统计学差异（p<0.05）。大体标本显示治疗实验犬脾脏组织愈合良好，未见粘连。第7、14、21天组织病理学检查未见明显异物及异物肉芽肿，可见红髓结构逐渐修复。
结论在超声造影引导下成功建立迟发性脾破裂模型，针对其损伤区域在超声造影引导下注射止血剂止血，实现了迟发性脾破裂的快速、微创治疗。探讨研究了新型止血药物可注射性明胶基止血剂用于脾脏外伤止血治疗的应用价值，为临床治疗提供了初步的实验依据。
Objective:①To establish the animal model of delayed splenic rupture under theguidance of contrast-enhanced ultrasonography.②To explore the value of theappliance of hemostatic agents injected directly into injury site for delayed splenicrupture under the guidance of contrast-enhanced ultrasonography.③To evaluateefficacy and safety of hemostatics of injected gelatin matrix (HIGM) for treatingsplenic trauma in canine model.
Material and methods：①A total15mongrel dogs were anesthetized andlaparotomized. The hematoma was formed on the spleen using external force. Thehematoma was ruptured by beating the abdominal wall after72hours. Conventianalultrasound and CEUS were used to detect traumatic lesions of spleen before and afterimpacting. The results of CEUS were compared with those of CECT.②A total14mongrel dogs were anesthetized and laparotomized. The hematoma was formed onthe spleen. Hemocoagulase2mL combined with α-cyanoacrylate1mL were injecteddirectly into injury sites under the guidance of CEUS in splenic trauma. Conventianalultrasound and CEUS were used to detect the injury area and ascites at1st,3rd,7th,14th,21thday. The spleen was harvested on the21thday for gross and pathologicalexamination.③A total of24commercial hybrid dogs underwent celiotomy with creationof uniformly blunt splenic trauma lesion of4cmx4cmx2.5cm (length, width, depth,respectively) by hemostatic clamp. Subjects were prospectively randomized into2groups.The treatment group were treated with HIGM under the guidance of CEUS, the positivecontrol group received thrombin solution. Conventional ultrasound and CEUS wereperformed to record the ascites and the splenic lesion areas at1st,3rd,7th,14th,21thday. Thefine needle biopsy and splenectomy were performed for histopathologic examination.
Result：①In4dogs, the hematoma showed by CEUS was gradually reduced during72hours. The CEUS results showed that the splenic hematoma in11canine wasformed continuously during a72hours period and the hematoma area graduallyincreased. The hematoma was ruptured after impacting the abdominal wall.Conventional ultrasound showed that the hamatoma was ill-defined and ascites wasclearly recorded. CEUS results showed that the hematoma was ruptured and activebleeding in the injury site. These conditions were demonstrated via CTscanning.②All animals survived.After injection of hemocoagulase combined withα-cyanoacrylate under the guidance of CEUS, CEUS exam demonstrated that activebleeding disappeared. At4time points, CEUS showed that the aera of hematoma wassignificantly decreased without active bleeding. Conventional ultrasound showed thatthe ascites was decreased. Pathologic examination revealed that the injury site treatedwas covered with glue membrane and no hematoma was observed.③All animals in2groups survived. All dogs succeed stopping hemorrhage after injection of HIGM underCEUS guidence. The area of injury site was gradually reduced at1st,3rd,7thday and all dogs(n=12) were not found splenic lesion at14thand21thday in HIGM group. The splenic lesionwas found in the postive group at1st,3rd,7th, and14thday and all dogs (n=12) were notfound splenic lesion at21thday. At1st,3rdand7thday post-injection, lesion areas werestatistically significant between2groups (p<0.05, all).F ree intraperitoneal fluid was notfound by conventional ultrasound at3rd,7th,14thand21thday in HIGM group. The samecondiction in postive group was14thand21thday. At1st,3rdand7thday post-injection, freeintraperatitoneal fluid were statistically significant between2groups (p<0.05, all).Histopathologic examination showed that there was no no foreign body and foreign bodygranuloma present and the structure of red pulp was repair at7th,14thand21thday. Grossanatomy showed that the splenic injury site was recoved completely without complications.
Conclusion: A delayed splenic rupture canine model was established successfullyunder the guidance of CEUS. The hemostatic agents injection therapy for splenictruama under the guidance of CEUS is effective, safe and no adverse effect, whichcarry out the minimal invasive treatment of splenic trauma. This study explored the value of HIGM for hemostasis of splenic trauma, and provided a preliminary experimentalevidence for clinical treatment.
材料和方法①15只健康杂种犬常规麻醉，开腹制作脾脏血肿，72小时后以小型撞击器撞击实验犬腹壁造成血肿破裂，血肿破裂后前后均行常规超声、超声造影及增强CT检查。观察血肿破裂前后常规超声、超声造影表现，探讨其结果与增强CT的对照研究；②14只健康杂种犬常规麻醉，开腹制作迟发性脾破裂动物模型在超声造影引导下先后多点注射蛇毒凝血酶2ml和α-氰基丙烯酸酯1mL，分别在术后、第1天、第3天、第7天、第14天及第21天行常规超声和超声造影检查，观察脾脏损伤区域面积和腹腔积液情况，脾切除术后行病理学检查；③24只健康杂种犬常规麻醉，开腹后暴露脾脏，用止血钳在脾脏膈面制作长、宽、深分别为4cm、4cm、2.5cm的脾脏实质锐器伤。实验犬随机分为两组，治疗组在超声造影引导下注射4ml HIGM，阳性对照组注射4ml蛇毒凝血酶和α-氰基丙烯酸酯对创伤灶行局部注射治疗，通过超声造影观察即刻疗效，并在第1天、第3天、第7天、第14天及第21天行常规超声及超声造影分别观察记录腹腔积液和创伤灶面积，并于第21天行脾切除术，通过大体标本观察脾脏愈合情况并行组织病理学检查。
结果①4只实验犬脾脏血肿面积明显缩小，72小时后血肿消失。11只实验犬脾脏血肿形成，常规超声对血肿边界显示不清晰，而超声造影可清晰显示血肿边界，大小，并观测到72小时后血肿面积明显增大。小型撞击器击打腹壁后，常规超声对创伤灶显示不清，可清晰显示腹腔积液，超声造影可清晰显示血肿破裂，部分血肿可见活动性出血。增强CT证实超声造影检查结果。②治疗组实验犬均存活。脾脏创伤灶经蛇毒凝血酶和α-氰基丙烯酸酯联合注射后，超声造影显示活动性出血消失，局部注射α-氰基丙烯酸酯处呈强回声。治疗后4个时间点观察，超声造影显示血肿面积明显缩小并未见活动性出血，常规超声显示腹腔积液减少。剖腹探查见大体标本显示创伤灶完全愈合，局部可见大网膜贴附，未见明确的并发症发生。③治疗组及阳性对照组所有实验犬均存活。治疗组在超声造影引导下注射HIGM后，损伤区域未见活动性出血，第1、3、7天创伤灶面积逐渐缩小，第14、21天所有实验犬（n=12）均未见创伤灶回声，阳性对照组实验犬于第1、3、7、14天可见创伤灶回声，第21天所有实验犬（n=12）未见创伤灶回声，且在第1、3、7天两组间创伤灶面积有显著统计学差异（p<0.05）。常规超声显示第3、7、14、21天治疗组未见腹腔积液，阳性对照组第14、21天未见腹腔积液，在第1、3、7天两组间腹腔积液测量值有明显统计学差异（p<0.05）。大体标本显示治疗实验犬脾脏组织愈合良好，未见粘连。第7、14、21天组织病理学检查未见明显异物及异物肉芽肿，可见红髓结构逐渐修复。
结论在超声造影引导下成功建立迟发性脾破裂模型，针对其损伤区域在超声造影引导下注射止血剂止血，实现了迟发性脾破裂的快速、微创治疗。探讨研究了新型止血药物可注射性明胶基止血剂用于脾脏外伤止血治疗的应用价值，为临床治疗提供了初步的实验依据。
Objective:①To establish the animal model of delayed splenic rupture under theguidance of contrast-enhanced ultrasonography.②To explore the value of theappliance of hemostatic agents injected directly into injury site for delayed splenicrupture under the guidance of contrast-enhanced ultrasonography.③To evaluateefficacy and safety of hemostatics of injected gelatin matrix (HIGM) for treatingsplenic trauma in canine model.
Material and methods：①A total15mongrel dogs were anesthetized andlaparotomized. The hematoma was formed on the spleen using external force. Thehematoma was ruptured by beating the abdominal wall after72hours. Conventianalultrasound and CEUS were used to detect traumatic lesions of spleen before and afterimpacting. The results of CEUS were compared with those of CECT.②A total14mongrel dogs were anesthetized and laparotomized. The hematoma was formed onthe spleen. Hemocoagulase2mL combined with α-cyanoacrylate1mL were injecteddirectly into injury sites under the guidance of CEUS in splenic trauma. Conventianalultrasound and CEUS were used to detect the injury area and ascites at1st,3rd,7th,14th,21thday. The spleen was harvested on the21thday for gross and pathologicalexamination.③A total of24commercial hybrid dogs underwent celiotomy with creationof uniformly blunt splenic trauma lesion of4cmx4cmx2.5cm (length, width, depth,respectively) by hemostatic clamp. Subjects were prospectively randomized into2groups.The treatment group were treated with HIGM under the guidance of CEUS, the positivecontrol group received thrombin solution. Conventional ultrasound and CEUS wereperformed to record the ascites and the splenic lesion areas at1st,3rd,7th,14th,21thday. Thefine needle biopsy and splenectomy were performed for histopathologic examination.
Result：①In4dogs, the hematoma showed by CEUS was gradually reduced during72hours. The CEUS results showed that the splenic hematoma in11canine wasformed continuously during a72hours period and the hematoma area graduallyincreased. The hematoma was ruptured after impacting the abdominal wall.Conventional ultrasound showed that the hamatoma was ill-defined and ascites wasclearly recorded. CEUS results showed that the hematoma was ruptured and activebleeding in the injury site. These conditions were demonstrated via CTscanning.②All animals survived.After injection of hemocoagulase combined withα-cyanoacrylate under the guidance of CEUS, CEUS exam demonstrated that activebleeding disappeared. At4time points, CEUS showed that the aera of hematoma wassignificantly decreased without active bleeding. Conventional ultrasound showed thatthe ascites was decreased. Pathologic examination revealed that the injury site treatedwas covered with glue membrane and no hematoma was observed.③All animals in2groups survived. All dogs succeed stopping hemorrhage after injection of HIGM underCEUS guidence. The area of injury site was gradually reduced at1st,3rd,7thday and all dogs(n=12) were not found splenic lesion at14thand21thday in HIGM group. The splenic lesionwas found in the postive group at1st,3rd,7th, and14thday and all dogs (n=12) were notfound splenic lesion at21thday. At1st,3rdand7thday post-injection, lesion areas werestatistically significant between2groups (p<0.05, all).F ree intraperitoneal fluid was notfound by conventional ultrasound at3rd,7th,14thand21thday in HIGM group. The samecondiction in postive group was14thand21thday. At1st,3rdand7thday post-injection, freeintraperatitoneal fluid were statistically significant between2groups (p<0.05, all).Histopathologic examination showed that there was no no foreign body and foreign bodygranuloma present and the structure of red pulp was repair at7th,14thand21thday. Grossanatomy showed that the splenic injury site was recoved completely without complications.
Conclusion: A delayed splenic rupture canine model was established successfullyunder the guidance of CEUS. The hemostatic agents injection therapy for splenictruama under the guidance of CEUS is effective, safe and no adverse effect, whichcarry out the minimal invasive treatment of splenic trauma. This study explored the value of HIGM for hemostasis of splenic trauma, and provided a preliminary experimentalevidence for clinical treatment.
引文
1.王正国,全国道路交通事故流行病学19年回顾.中华创伤杂志,1998.14(4): p.242-246.
2.裘法祖，主编,外科学.第四版.北京：人民卫生出版社,1996: p.409.
3. George D. Zuidema, R.B.R., Walter F. Ballinger, The Management ofTrauma,3rd ed. Philadelphia: WB Saunders Company,1999: p.459-459.
4. Parithivel, V.S., et al., Delayed presentation of splenic injury: still a commonsyndrome. Int Surg,2002.87(2): p.120-4.
5.杨春明，李纪仑,延迟性脾破裂的诊治问题（附17例报告）.实用外科杂志,1986.6（8）: p.411-412.
6. Lorimer, W.S., Jr., Occult Rupture of the Spleen. Arch Surg,1964.89: p.434-40.
7. Spacek, V., P. Jandik, and K. Smejkal, Delayed splenic rupture: an unusualcause of acute surgical abdomen. Acta Medica (Hradec Kralove),2002.45(1):p.45-6.
8. Burd, R.S. and M.A. Helikson, Delayed splenic rupture following low impactactivity. J Pediatr Surg,2000.35(10): p.1529.
9. Deva, A.K. and J.F. Thompson, Delayed rupture of the spleen51/2years afterconservative management of traumatic splenic injury. Aust N Z J Surg,1996.66(7): p.494-5.
10. Nast-Kolb, D., H.J. Bail, and G. Taeger,[Current diagnostics forintra-abdominal trauma]. Chirurg,2005.76(10): p.919-26.
11. Porter, R.S., et al., Use of ultrasound to determine need for laparotomy intrauma patients. Ann Emerg Med,1997.29(3): p.323-30.
12. Scalea, T.M., et al., Focused Assessment with Sonography for Trauma (FAST):results from an international consensus conference. J Trauma,1999.46(3): p.466-72.
13. Poletti, P.A., et al., Blunt abdominal trauma: should US be used to detect bothfree fluid and organ injuries? Radiology,2003.227(1): p.95-103.
14. Siniluoto, T.M., et al., Ultrasonography in traumatic splenic rupture. ClinRadiol,1992.46(6): p.391-6.
15. Minarik, L., et al., Diagnostic imaging in the follow-up of nonoperativemanagement of splenic trauma in children. Pediatr Surg Int,2002.18(5-6): p.429-31.
16. Catalano, O., et al., Active abdominal bleeding: contrast-enhanced sonography.Abdom Imaging,2006.31(1): p.9-16.
17. Miele, V., et al., Contrast enhanced ultrasound with second generation contrastagent in traumatic liver lesions. Radiol Med,2004.108(1-2): p.82-91.
18. Oakes, D.D. and A.C. Charters, Changing concepts in the management ofsplenic trauma. Surg Gynecol Obstet,1981.153(2): p.181-5.
19. Buntain, W.L. and H.R. Gould, Splenic trauma in children and techniques ofsplenic salvage. World J Surg,1985.9(3): p.398-409.
20.刘唐彬,小儿血液科与脾外科：附119例分析.实用外科杂志,1986.8: p.413-414.
21. Krivit, W., Overwhelming postsplenectomy infection. Am J Hematol,1977.2(2): p.193-201.
22. Upadhyaya P, S.J., Splenic trauma in children. Surg Gynecol Obstet,1968.126(4): p.781-190.
23. Upadhyaya, P., N.C. Nayak, and S. Moitra, Experimental study of splenictrauma in monkeys. J Pediatr Surg,1971.6(6): p.767-73.
24.夏穗生,我国脾脏外科的发展回顾.中国实用外科杂志,2004.24（12）: p.705-707.
25.乔海泉，代文杰，刘冰等,脾损伤的脾保留手术10年经验总结.中华肝胆外科杂志,2002.8(6): p.34.
26. Stein, D.M. and T.M. Scalea, Nonoperative management of spleen and liverinjuries. J Intensive Care Med,2006.21(5): p.296-304.
27.谭敏，辻羲彦，吴志棉，等,腹腔镜技术在脾切除术中的应用.中华外科杂志,2001.39(8): p.599-601.
28.祝智军，李大伟，郑蓉蓉,手助腹腔镜脾切除术治疗外伤性脾破裂.中华创伤杂志,2003.19(10): p.583-584.
29.张耘，宋建宁，宋林学，等,腹腔镜切除治疗外伤性脾破裂.中国微创外科杂志,2005.11: p.886-887.
30. Hagiwara, A., et al., Nonsurgical management of patients with blunt splenicinjury: efficacy of transcatheter arterial embolization. AJR Am J Roentgenol,
1996.167(1): p.159-66.
31.徐迎讯,脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察[J/CD].中华普通外科学文献：电子版,2007.1(4): p.228-229.
32.陆永良，韩春蕃，吴平，郑少俊，顾凤元,脾动脉栓塞止血治疗外伤性脾破裂.中华外科杂志,1997.35(1): p.31-32.
33.刘强，李铎，李建新，等,选择性脾动脉栓塞与脾修补术治疗外伤性脾破裂的比较.中华肝胆外科杂志,2005.11(11): p.752-754.
34.鞠新华，赵海英，于宏，等,微波在保脾手术中的临床应用（附5例报告）.肝胆外科杂志,2003.11（1）: p.57-58.
35. Tabuse, K., Basic knowledge of a microwave tissue coagulator and its clinicalapplications. J Hepatobiliary Pancreat Surg,1998.5(2): p.165-72.
36.吕发勤，唐杰，张惠琴，等.超声造影引导经皮注射治疗严重脾破裂出血.中华超声影像学杂志,2008.17(7): p.598-600.
37. Neveleff, D.J., L.W. Kraiss, and C.S. Schulman, Implementing methods toimprove perioperative hemostasis in the surgical and trauma settings. AORN J,
2010.92(5): p. S1-15.
38. Sarfati MR, D.D., Kraiss LW, Galt SW, Severe coagulopathy followingintraoperative use of topical thrombin. Ann Vasc Surg,2004.18(3): p.349-351.
39. Tomizawa, Y., Clinical benefits and risk analysis of topical hemostats: areview. J Artif Organs,2005.8(3): p.137-42.
40. Low RK, M.M., Goodnight JE Microfibrillar collagen hemostat duringlaparoscopically derected liver biopsy. J Laparoendosc Surg,1993.3: p.415-420.
41.邹勇，黄雅钦，夏宇正,明胶与天然聚合物复合制备创伤下敷料的研究进展.功能材料,2004.35: p.2310-2313.
42. Foster, R.P., Delayed haemorrhage from the ruptured spleen. Br J Surg,1970.57(3): p.189-92.
43. Benjamin, C.I., L.H. Engrav, and J.F. Perry, Jr., Delayed rupture or delayeddiagnosis of rupture of the spleen. Surg Gynecol Obstet,1976.142(2): p.171-2.
44.李正,董秀珍,尤富生,等家兔腹内出血动物模型的建立.中国比较医学杂志,2006.16(4)(217-219).
45. Buntain, W.L., H.R. Gould, and K.I. Maull, Predictability of splenic salvageby computed tomography. J Trauma,1988.28(1): p.24-34.
46. Spencer, D.D. and J.J. Ragland, Delayed splenic rupture: an unusual cause ofthe acute surgical abdomen. J Am Osteopath Assoc,1993.93(2): p.249-51.
47. Fitoz, S., et al., Post-traumatic intrasplenic pseudoaneurysms with delayedrupture: color Doppler sonographic and CT findings. J Clin Ultrasound,2001.29(2): p.102-4.
48. Lencioni, R., D. Cioni, and C. Bartolozzi, Tissue harmonic andcontrast-specific imaging: back to gray scale in ultrasound. Eur Radiol,2002.12(1): p.151-65.
49. Phillips, P. and E. Gardner, Contrast-agent detection and quantification. EurRadiol,2004.14Suppl8: p. P4-10.
50. Blaivas, M., et al., Tissue harmonic imaging improves organ visualization intrauma ultrasound when compared with standard ultrasound mode. AcadEmerg Med,2002.9(1): p.48-53.
51. McGahan, J.P., et al., Appearance of solid organ injury with contrast-enhancedsonography in blunt abdominal trauma: preliminary experience. AJR Am JRoentgenol,2006.187(3): p.658-66.
52. Catalano, O., et al., Blunt hepatic trauma: evaluation with contrast-enhancedsonography: sonographic findings and clinical application. J Ultrasound Med,
2005.24(3): p.299-310.
53.梁峭嵘,梁彤,黄春燕,等,超声造影在肝脏外伤鉴别诊断中的应用价值中国超声医学志,2006.22(10): p.760-763.
54. Catalano, O., et al., Real-time, contrast-enhanced sonography: a new tool fordetecting active bleeding. J Trauma,2005.59(4): p.933-9.
55. Amendola, M.A. and D. Nunez, Unenhanced CT scans in identifyinghematomas after blunt abdominal trauma. AJR Am J Roentgenol,1995.165(6): p.1544-5.
56.潘贤,新编药物实用全书北京:中国中医药出版社,1998: p.694-695.
57.朱明炜,曹金铎,贾振庚,等,蛇毒血凝酶在腹部手术中止血作用以及对凝血功能的影响中华外科杂志,2002.40(8): p.581-584.
58.李小敏,窦晓晖,王燕群立止血局部注射在耳鼻咽喉科出血中的应用.广东药学院学报,2005.21(1)(107-110).
59.毛巧云,陈雪英,立止血的临床应用与观察体会.海峡药学,2000.12(3): p.96-97.
60. Mankad, P.S. and M. Codispoti, The role of fibrin sealants in hemostasis. AmJ Surg,2001.182(2Suppl): p.21S-28S.
61. Schips, L., et al., Autologous fibrin glue using the Vivostat system forhemostasis in laparoscopic partial nephrectomy. Eur Urol,2006.50(4): p.801-5.
62. Shen, H.B., et al., Clinical application of laparoscopic spleen-preservingoperation in traumatic spleen rupture. Chin J Traumatol,2005.8(5): p.293-6.
63. Landegren, T., et al., Long-term results of peripheral nerve repair: acomparison of nerve anastomosis with ethyl-cyanoacrylate and epineuralsutures. Scand J Plast Reconstr Surg Hand Surg,2006.40(2): p.65-72.
64. Moretti Neto, R.T., et al., In vivo qualitative analysis of the biocompatibilityof different cyanoacrylate-based adhesives. Braz Oral Res,2008.22(1): p.43-7.
65. Kameda, N., et al., Management of gastric fundal varices without gastro-renalshunt in15patients. World J Gastroenterol,2008.14(3): p.448-53.
66. Fortelny, R.H., et al., Cyanoacrylate tissue sealant impairs tissue integration ofmacroporous mesh in experimental hernia repair. Surg Endosc,2007.21(10):p.1781-5.
67. Biggs, G., et al., Treatment of splenic injury during laparoscopic nephrectomywith BioGlue, a surgical adhesive. Urology,2005.66(4): p.882.
68. Kim, B.Y., et al., Microvascular anastomosis using cyanoacrylate adhesives. JReconstr Microsurg,2004.20(4): p.317-21.
69. Fotiadis, C., et al., The use of isobutylcyanoacrylate as a tissue adhesive inabdominal surgery. Acta Chir Belg,2005.105(4): p.392-6.
70.刘万章,张在新, α-氰基丙烯酸酯瞬间胶粘剂的现状和展望.中国胶粘剂,
2007.16(2): p.41-44.
71. Smith, J.S., Jr., R.N. Cooney, and P. Mucha, Jr., Nonoperative management ofthe ruptured spleen: a revalidation of criteria. Surgery,1996.120(4): p.745-50;discussion750-1.
72. Heuer, M., et al., No further incidence of sepsis after splenectomy for severetrauma: a multi-institutional experience of The trauma registry of the DGUwith1,630patients. Eur J Med Res,2010.15(6): p.258-65.
73. Sharma, O.P., et al., Assessment of nonoperative management of blunt spleenand liver trauma. Am Surg,2005.71(5): p.379-86.
74. Goffette, P.P. and P.F. Laterre, Traumatic injuries: imaging and intervention inpost-traumatic complications (delayed intervention). Eur Radiol,2002.12(5):p.994-1021.
75. Lau, H., Fibrin sealant versus mechanical stapling for mesh fixation duringendoscopic extraperitoneal inguinal hernioplasty: a randomized prospectivetrial. Ann Surg,2005.242(5): p.670-5.
76. Noh, D.Y., et al.,[Therapeutic effect of the endoscopicN-butyl-2-cyanoacrylate injection for acute esophagogastric variceal bleeding:comparison with transjugular intrahepatic portosystemic shunt]. Korean JGastroenterol,2004.43(3): p.186-95.
77. Thorelius, L., Contrast-enhanced ultrasound for extrahepatic lesions:preliminary experience. Eur J Radiol,2004.51Suppl: p. S31-8.
78. Xie, H., et al., Concentrated albumin as a biological glue for hemorrhagecontrol on hepatic resection with argon beam coagulation. J Biomed MaterRes B Appl Biomater,2004.71(1): p.84-9.
79. Koide, M., et al., A new type of biomaterial for artificial skin:dehydrothermally cross-linked composites of fibrillar and denatured collagens.J Biomed Mater Res,1993.27(1): p.79-87.
80. Stanton JS, S.V., Bentley G, et al, The growth of chondrocytes usinggelfoam(R) as a biodegradable scaffold.. J Mater Sci—Mater Med,1995.6: p.739–744.
81. JE., F., Adv Enzymol,1983.54: p.2-56.
82. Dube M, S.C., Neidhart S, et al.,. Reinhold Carle Eur Food Res Techno,2007.225: p.287-299.
83. JE, F., Transglutaminases. Biochemistry,1980.49: p.517-531.
84. Falcone P, S.D., Del Duca S Comparative studies of transglutaminaseactivity and substrates in different organs of helianthus tuverosus. PlantPhysiol,1993.142(): p.263-273.
85. Yasueda H, K.Y., Motoki M Purification and characterization of atissue-type transglutaminase from red sea bream. Bioscience BiotechnologyBiochemistry,1994.58: p.2041-2045.
86. Yasueda, H., Y. Kumazawa, and M. Motoki, Purification and characterizationof a tissue-type transglutaminase from red sea bream (Pagrus major). BiosciBiotechnol Biochem,1994.58(11): p.2041-5.
87.贺雷雨，李新华，王璋,谷氨酰胺转胺酶及其在食品加工中的应用.中国食物与营养,2004.4: p.22-24.
88. Lv, F., et al., Hemostatic agents injected directly into hepatic injury sites forliver trauma hemorrhage under the guidance of contrast-enhanced ultrasound:an animal experiment. Ultrasound Med Biol,2008.34(10): p.1604-9.
89. Tang, J., et al., Contrast-enhanced sonographic guidance for local injection ofa hemostatic agent for management of blunt hepatic hemorrhage: a caninestudy. AJR Am J Roentgenol,2008.191(3): p. W107-11.
90. Tang, J., et al., Comparison of gray-scale contrast-enhanced ultrasonographywith contrast-enhanced computed tomography in different grading of blunthepatic and splenic trauma: an animal experiment. Ultrasound Med Biol,2009.35(4): p.566-75.
91. Desai, P.J., et al., Hand-assisted laparoscopic partial nephrectomy in theporcine model using gelatin matrix hemostatic sealant without hilar occlusion.J Endourol,2005.19(5): p.566-9.
92. Gill, I.S., et al., Improved hemostasis during laparoscopic partial nephrectomyusing gelatin matrix thrombin sealant. Urology,2005.65(3): p.463-6.
93. Hick, E.J., et al., Gelatin matrix treatment of complex renal injuries in aporcine model. J Urol,2005.173(5): p.1801-4.
94. Klemcke, H.G., Evaluation of FloSeal as a potential intracavitary hemostaticagent. J Trauma,2006.60(2): p.385-9.
95. Leixnering, M., et al., Gelatin thrombin granules for hemostasis in a severetraumatic liver and spleen rupture model in swine. J Trauma,2008.64(2): p.456-61.
96. Baumann, A. and M. Caversaccio, Hemostasis in endoscopic sinus surgeryusing a specific gelatin-thrombin based agent (FloSeal). Rhinology,2003.41(4): p.244-9.
97. Lee, D.I., et al., Sealing percutaneous nephrolithotomy tracts with gelatinmatrix hemostatic sealant: initial clinical use. J Urol,2004.171(2Pt1): p.575-8.
98. Richter, F., et al., Improvement of hemostasis in open and laparoscopicallyperformed partial nephrectomy using a gelatin matrix-thrombin tissue sealant(FloSeal). Urology,2003.61(1): p.73-7.
1Georged Zuidema. The management of trauma,3th ed．Philadelphia:WBSaunders Company,1999,458-459.
2Vellore S. Parithivel Sai B. Sajja, Amit Basu, Moshe Schein. Delayedpresentation of spleen injury: still a common syndrome. Int Surg,2002,87(2):120-124
3陈维鹏，脾外科学，山东：山东科学技术出版社，1989：108-11
4杨春明，李纪仑.延迟性脾破裂的诊治问题（附17例报告）.实用外科杂志，1986，6（8）：411-412．
5Lorimer WS Jr．Occult rupture of the spleen.Arch Surg,1964,89:434-440
6Spacek V, Jandik P, Smejkal K. Delayed splenic rupture: an unusual cause ofacute surgical abdomen. Acta Medica,2002,45(1):45-46.
7Burd RS, Helikson MA. Delayed splenic rupture following low impact activity. JPediatr Surg,2000,35(10):1529.
8Deva AK, Thompson JF. Delayed rupture of the spleen5.5years afterconservative management of traumatic splenic injury. Aust N Z J Surg,1996,66(6):494-495.
9Simpson RA, Ajuwon R. Occult splenic injury: delayed presentation manifestingas jaundice. Emerg Med J,2001,18(6):504-505.
10Hammond JC, Canal DF, Broadie TA. Nonoperative management of adult blunthepatic trauma in municipal trauma center. Am Surg,1992，58(9):551-555.
11范康川，郭吉生，周惠彬，脾破裂延迟性出血.现代诊断与治疗，1992：（1）：29-30.
12FAST Consensus Conference Committee. Focused assessment with sonographyfor trauma (FAST): results from an international consensus conference. J Trauma,1999,46:466-4721.
13Poletti PA, Kinkel K, Vermeulen B, et al. Blunt abdominal trauma: should US beused to detect both free fluid and organ injuries? Radiology April,2003,227(1):95-103.
14李国杰，周永昌.急诊超声对钝性腹部创伤的内脏破裂出血的研究.中国超声医学杂志，2002，18（1）：29-33.
15Siniluoto TM, P iv nsalo MJ, Lanning FP, et al. Ultrasonography in traumaticspleen rupture. Clin Rediol,1992,46(6):391-396.
16吕发勤，唐杰，罗渝昆，李志艳，李俊来，黎檀实，超声造影在腹部实质脏器创伤快速分类治疗中的价值[J/CD].中华超声学杂志：电子版：2009：6（1）：25-29.
17Catalano O, Cusati B, Nunziata A, Siani A. Real-time, contrast-specificsonography imaging of acute splenic disorders: a pictorial review, Emerg Radiol,2004,11(1):15-21
18梁峭嵘，黄春燕，梁彤，等.超声造影在脾外伤评估分级诊断中的临床应用[J/CD]..中华超声医学杂志：电子版，2008：5（2）：288-294.
19Impellizzeri P, Cutrupi A, Chirico MR, et al．Conservative treatment of pediatricspleen trauma, Twenty years of experience． Pediatr Med Chir,2007,29(1):38-43.
20Jonas Rydberg, Kenneth A. Buckwalter, Karen S. Caldemeyer, Michael D.Phillps, Dewey J. Conces, Jr, Alex M. Aisen, Scott A. Persohn, Kenyon K.Kopecky, Multislicion CT: scanning techniques and clinicalapplications.Radiographics,2000,20(6):1787-1806.
21Becker CD, Spring P, Gl ttli A, et al. Blunt splenic trauma in adults: can CTfindings be used to determine the need for surgery? AJR Am JRoentgenol,1994,162(2):343-347
22夏穗生，我国脾脏外科的发展回顾.中国实用外科杂志，2004，24（12）：705-707
23范士志，蒋耀光，现代创伤治疗学.人民军医出版社，2009：334-336
24吕发勤，唐杰，张惠琴，等.超声造影引导经皮注射治疗严重脾破裂出血.中华超声影像学杂志，2008：17（7）：598-600.
25谭敏，辻羲彦，吴志棉，等.腹腔镜技术在脾切除术中的应用.中华外科杂志，2001，39（8）：599-601.
26祝智军，李大伟，郑蓉蓉.手助腹腔镜脾切除术治疗外伤性脾破裂.中华创伤杂志，2003，19（10）：583-584.
27张耘，宋建宁，宋林学，等.腹腔镜切除治疗外伤性脾破裂.中国微创外科杂志，2005，（11）：886-887.
28徐迎讯.脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察[J/CD].中华普通外科学文献：电子版，2007，1（4）：228-229.
29陆永良，韩春蕃，吴平，郑少俊，顾凤元，脾动脉栓塞止血治疗外伤性脾破裂，中华外科杂志，1997，35（1）：31-32.
30Hagiwara A, Yukioka T, Ohta S.Nonsurgical management of patients with bluntsplenic injury: efficacy of transcatheter arterial embolization. Am J Roentgenol,1996,167(1):159-166.
31刘强，李铎，李建新，等.选择性脾动脉栓塞与脾修补术治疗外伤性脾破裂的比较.中华肝胆外科杂志，2005，11（11）：752-754.
32鞠新华，赵海英，于宏，等.微波在保脾手术中的临床应用（附5例报告）.肝胆外科杂志，2003，11（1）：57-58.
33Tabuse K. Basic knowledge of a microwave tissue and its clinical applications. JHepatobiliary Pancreat Surg,1998,5(5):560-563.
34乔海泉，代文杰，刘冰，等.脾损伤的脾保留手术-10年经验总结.中华肝胆外科杂志，2002，8（6）：343-345.
35Moore EE, Cogbill TH，Jurkovich G J, et al.Organ injury scaling: spleen andliver (1994revision). J Trauma,1995,38(3):323-324.
36Federle MP, Jeffrey RB Jr. Hemoperitoneum studied by computed tomography.Radiology,1983,148(1):187-192.
37Godley CD, Warren RL, Sheridan RL, et al. Nonoperative management of bluntsplenic injury in adults: age over55years as a powerful indicator for failure. JAm Coll Surg,1996;183(2):133-139.
38Hawkins ML, Wynn JJ, Schmacht DC, et al. Nonoperative management of liverand/or splenic injuries: effect on resident surgical experience. Am Surg,1998,64(6):552-556.
39Goan YG, Huang MS, Lin JM. Nonoperative management for extensive hepaticand splenic injuries with significant henoperitoneum in adults. JTrauma,1998,45(2):360-364.
40张牧，姜洪池.保脾措施今日观.中国实用外科杂志，2009，29（5）：377-378.
41Richardson JD. Changes in the management of injuries to the liverand spleen. JAm Coll Surg,2005,200(5):648-669.
42李小敏,窦晓晖,王燕群.立止血局部注射在耳鼻咽喉科出血中的应用.广东药学院学报,2005;21(1):107-110.
43毛巧云,陈雪英.立止血的临床应用与观察体会.海峡药学,2000;12(3):96-97.
44潘贤,主编.新编药物实用全书.北京:中国中医药出版社,1998.695-695.
45朱明炜,朝金铎,贾振庚,等.蛇毒血凝酶在腹部手术中止血作用以及对凝血功能的影响.中华外科杂志,2002;40(8):581-584.
46Schip s L, Dalpiaz O, Cestari A, et al. Autologous fibrin glue using the vivostatsystem for hemostasis in laparoscopic partial nephrectomy. Eur Urol,2006;50(4):801-805.
47Suri A, Mehta VS, Sarkar C. Microneural anastomosis with fibrin glue: anexperimental study. Neurol India,2002;50(1):23-26Suri A, Mehta VS, Sarkar C.Microneural anastomosis with fibrin glue: an experimental study. Neurol India,2002;50(1):23-26
48Canby-Hagino ED, Morey AF, Jatoi I, et al. Fibrin sealant treatment of splenicinjury during open and laparoscopic left radical nephrectomy. J Urol,2000;164(6):2004-2005.
49Mankad PS, Codispoti M. The role of fibrin sealants in hemostasis. Am J Surg,2001;182(Suppl2):21S-28S
50Ellman PI, Brett Reece T, Maxey TS, et al. Evaluation of an absorbablecyanoacrylate adhesive as a suture line sealant. J Surg Res,2005;125(2):161-167.
51Shen HB, Lu XM, Zheng QC, et al. Clinical application of laparoscopic spleen-preserving operation in traumatic spleen rupture. Chin J Traumatol,2005;8(5):293-296.
52Landegren T, Risling M, Brage A, et al. Long-term results of peripheral nerverepair: a comparison of nerve anastomosis with ethyl-cyanoacrylate and epineuralsutures. Scand J Plast Reconstr Surg Hand Surg.2006;40(2):65-72.
53Moretti Neto RT, Mello I, Moretti AB, et al. In vivo qualitative analysis of thebiocompatibility of different cyanoacrylate-based adhesives. Braz Oral Res,2008;22(1):43-47.
54Kameda N, Higuchi K, Shiba M,et al. Management of gastric fundal variceswithout gastro-renal shunt in15patients. World J Gastroenterol,2008;14(3):448-453.
55Fortelny RH, Petter-Puchner AH, Walder N, et al. Cyanoacrylate tissue sealantimpairs tissue integration of macroporous mesh in experimental hernia repair.Surg Endosc,2007;21(10):1781-1785.
56Biggs G, Hafron J, Feliciano J, et al. Treatment of splenic injury duringlaparoscopic nephrectomy with BioGlue, a surgical adhesive. Urology,2005;66(4):882.
57Kim BY, Choi BH， Huh JY, et a1. Microvascular anastomosis usingcyanoacrylate adhesives. J Recormtr Microsurg,2004;20(4):317-321.
58Fotiadis C, Leventis I, Adamis S, et al. The use of isobutylcyanoacrylate as atissue adhesive in abdominal surgery. Acta Chir Belg,2005;105(4):392-396.
59刘万章,张在新. a-氰基丙烯酸酯瞬间胶粘剂的现状和展望.中国胶粘剂,2007;16(2):41-44.
60Georged Zuidema. The Management of Trauma,3rd ed． Philadelphia:WBSaunders Company,1999:458-459.
61Parithivel VS, Sajja SB, Basu A, et al. Delayed presentation of splenic injury: stilla common syndrome. Int Surg,2002,87(2):120-124
62陈维鹏，脾外科学，山东：山东科学技术出版社，1989：108-11
63杨春明，李纪仑.延迟性脾破裂的诊治问题（附17例报告）.实用外科杂志，1986，6（8）：411-412．
64Lorimer WS Jr．Occult rupture of the spleen.Arch Surg,1964,89:434-440
65Spacek V, Jandik P, Smejkal K. Delayed splenic rupture: an unusual cause ofacute surgical abdomen. Acta Medica,2002,45(1):45-46.
66Burd RS, Helikson MA. Delayed splenic rupture following low impact activity. JPediatr Surg,2000,35(10):1529.
67Deva AK, Thompson JF. Delayed rupture of the spleen5.5years afterconservative management of traumatic splenic injury. Aust N Z J Surg,1996,66(6):494-495.
68Simpson RA, Ajuwon R. Occult splenic injury: delayed presentation manifestingas jaundice. Emerg Med J,2001,18(6):504-505.
69Hammond JC, Canal DF, Broadie TA. Nonoperative management of adult blunthepatic trauma in municipal trauma center. Am Surg,1992，58(9):551-555.
70范康川，郭吉生，周惠彬，脾破裂延迟性出血.现代诊断与治疗，1992：3（1）：29-30.
71FAST Consensus Conference Committee. Focused assessment with sonographyfor trauma (FAST): results from an international consensus conference. J Trauma,1999,46:466-4721.
72Poletti PA, Kinkel K, Vermeulen B, et al. Blunt abdominal trauma: should US beused to detect both free fluid and organ injuries? Radiology April,2003,227(1):95-103.
73李国杰，周永昌.急诊超声对钝性腹部创伤的内脏破裂出血的研究.中国超声医学杂志，2002，18（1）：29-33.
74Siniluoto TM, P iv nsalo MJ, Lanning FP, et al. Ultrasonography in traumaticspleen rupture. Clin Rediol,1992,46(6):391-396.
75吕发勤，唐杰，罗渝昆，李志艳，李俊来，黎檀实，超声造影在腹部实质脏器创伤快速分类治疗中的价值[J/CD].中华超声学杂志：电子版：2009：6（1）：25-29.
76Catalano O, Cusati B, Nunziata A, Siani A. Real-time, contrast-specificsonography imaging of acute splenic disorders: a pictorial review, Emerg Radiol,2004,11(1):15-21
77梁峭嵘，黄春燕，梁彤，等.超声造影在脾外伤评估分级诊断中的临床应用[J/CD]..中华超声医学杂志：电子版，2008：5（2）：288-294.
78Impellizzeri P, Cutrupi A, Chirico MR, et al．Conservative treatment of pediatricspleen trauma, Twenty years of experience．Pediatr Med Chir,2007,29(1):38-43.
79Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanningtechniques and clinical applications. Radiographics,2000,20(6):1787-1806.
80Becker CD, Spring P, Gl ttli A, et al. Blunt splenic trauma in adults: can CTfindings be used to determine the need for surgery? AJR Am JRoentgenol,1994,162(2):343-347
81夏穗生，我国脾脏外科的发展回顾.中国实用外科杂志，2004，24（12）：705-707
82范士志，蒋耀光，现代创伤治疗学.人民军医出版社，2009：334-336
83吕发勤，唐杰，张惠琴，等.超声造影引导经皮注射治疗严重脾破裂出血.中华超声影像学杂志，2008：17（7）：598-600.
84谭敏，辻羲彦，吴志棉，等.腹腔镜技术在脾切除术中的应用.中华外科杂志，2001，39（8）：599-601.
85祝智军，李大伟，郑蓉蓉.手助腹腔镜脾切除术治疗外伤性脾破裂.中华创伤杂志，2003，19（10）：583-584.
86张耘，宋建宁，宋林学，等.腹腔镜切除治疗外伤性脾破裂.中国微创外科杂志，2005，（11）：886-887.
87徐迎讯.脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察[J/CD].中华普通外科学文献：电子版，2007，1（4）：228-229.
88陆永良，韩春蕃，吴平，郑少俊，顾凤元，脾动脉栓塞止血治疗外伤性脾破裂，中华外科杂志，1997，35（1）：31-32.
89Hagiwara A, Yukioka T, Ohta S.Nonsurgical management of patients with bluntsplenic injury: efficacy of transcatheter arterial embolization. Am J Roentgenol,1996,167(1):159-166.
90刘强，李铎，李建新，等.选择性脾动脉栓塞与脾修补术治疗外伤性脾破裂的比较.中华肝胆外科杂志，2005，11（11）：752-754.
91鞠新华，赵海英，于宏，等.微波在保脾手术中的临床应用（附5例报告）.肝胆外科杂志，2003，11（1）：57-58.
92Tabuse K. Basic knowledge of a microwave tissue and its clinical applications. JHepatobiliary Pancreat Surg,1998,5(5):560-563.
93乔海泉，代文杰，刘冰，等.脾损伤的脾保留手术-10年经验总结.中华肝胆外科杂志，2002，8（6）：343-345.
94Moore EE, Cogbill TH，Jurkovich G J, et al.Organ injury scaling: spleen andliver (1994revision). J Trauma,1995,38(3):323-324.
95Federle MP, Jeffrey RB Jr. Hemoperitoneum studied by computed tomography.Radiology,1983,148(1):187-192.
96Godley CD, Warren RL, Sheridan RL, et al. Nonoperative management of bluntsplenic injury in adults: age over55years as a powerful indicator for failure. JAm Coll Surg,1996;183(2):133-139.
97Hawkins ML, Wynn JJ, Schmacht DC, et al. Nonoperative management of liverand/or splenic injuries: effect on resident surgical experience. Am Surg,1998,64(6):552-556.
98Goan YG, Huang MS, Lin JM. Nonoperative management for extensive hepaticand splenic injuries with significant henoperitoneum in adults. JTrauma,1998,45(2):360-364.
99张牧，姜洪池.保脾措施今日观.中国实用外科杂志，2009，29（5）：377-378.
100Richardson JD. Changes in the management of injuries to the liverand spleen. JAm Coll Surg,2005,200(5):648-669.
1. Foster RP. Delayed haemorrhage from the ruptured spleen. Br J Surg1970;57:189-92.
2. Schwartz SI, Shires GT, Spencer FC. Principles of Surgery.5th ed. New York,NY: McGraw-Hill Book Company,1989:271-3.
3. Kluger Y, Paul DB, Raves JJ, et al. Delayed rupture of the spleen--myths, facts,and their importance: case reports and literature review. J Trauma1994;36:568-71.
4. Benjamin CI, Engrav LH, Perry JF Jr. Delayed rupture or delayed diagnosis ofrupture of the spleen. Surg Gynecol Obstet1976;142:171-2.
5. Berlatzky Y, Shiloni E, Anner H, et al."Delayed rupture of the spleen" ordelayed diagnosis of the splenic injury? Isr J Med Sci1980;16:659-64.
6. Cogbill TH, Moore EE, Jurkovich GJ, et al. Nonoperative management of bluntsplenic trauma: a multicenter experience. J Trauma1989;29:1312-7.
7. Richards JR, Schleper NH, Woo BD, et al. Sonographic assessment of bluntabdominal trauma: a4-year prospective study. J Clin Ultrasound2002;30:59-67.
8. Shanmuganathan K, Mirvis SE, Sherbourne CD, et al. Hemoperitoneum as thesole indicator of abdominal visceral injuries: a potential limitation of screeningabdominal US for trauma. Radiology1999;212:423-30.
9. Yoshii H, Sato M, Yamamoto S, et al. Usefulness and limitations ofultrasonography in the initial evaluation of blunt abdominal trauma. J Trauma1998;45:45-50.
10. Becker CD, Mentha G, Terrier F. Blunt abdominal trauma in adults: role of CT inthe diagnosis and management of visceral injuries. Part1: liver and spleen. EurRadiol1998;8:553-62.
11. Richards JR, Derlet RW. Computed tomography for blunt abdominal trauma inthe ED: a prospective study. Am J Emerg Med1998;16:338-42.
12. Xie H, Wolf RF, Burke AP, et al. Concentrated albumin as a biological glue forhemorrhage control on hepatic resection with argon beam coagulation. J BiomedMater Res B Appl Biomater2004;71:84-9.
13. Li Z, Dong XZ, You FS, et al. Establishment of animal model of intraperitonealbleeding in rabbits. Chin J Comparative Med2006;16:217-9.
14. Leen E, Angerson WJ, Yarmenitis S, et al. Multi-centre clinical study evaluatingthe efficacy of SonoVue (BR1), a new ultrasound contrast agent in Dopplerinvestigation of focal hepatic lesions. Eur J Radiol2002;41:200-6.
15. von Herbay A, Vogt C, Willers R, et al. Real-time imaging with the sonographiccontrast agent SonoVue: differentiation between benign and malignant hepaticlesions. J Ultrasound Med2004;23:1557-68.
16. Strobel D, Kleinecke C, H nsler J, et al. Contrast-enhanced sonography for thecharacterisation of hepatocellular carcinomas--correlation with histologicaldifferentiation. Ultraschall Med2005;26:270-6.
17. Albrecht T, Hohmann J, Oldenburg A, et al. Detection and characterisation ofliver metastases. Eur Radiol2004;14:P25-33.
18. Dang C, Schlater T, Bui H, et al. Delayed rupture of the spleen. Ann Emerg Med1990;19:399-403.
19. Zabinski EJ, Harkins HN. Delayed splenic rupture: A clinical syndromefollowing trauma. Arch Surg1943;46:186-212.
20. Sizer JS, Wayne E, Frederick PL. Delayed rupture of the spleen. Arch Surg1966;92:362-6.
21. Olsen WR, Polley TZ Jr. A second look at delayed splenic rupture. Arch Surg1977;112:422-5.
22. Farhat GA, Abdu RA, Vanek VW. Delayed splenic rupture: real or imaginary?Am Surg1992;58:340-5.
23. Scalea TM, Rodriguez A, Chiu WC, et al. Focused assessment with sonographyfor trauma (FAST): results from an international consensus conference. J Trauma1999;46:466-72.
24. Benya EC, Lim-Dunham JE, Landrum O, et al. Abdominal sonography inexamination of children with blunt abdominal trauma. AJR Am J Roentgenol2000;174:1613-6.
25. Richards JR, Schleper NH, Woo BD, et al. Sonographic assessment of bluntabdominal trauma: a4-year prospective study. J Clin Ultrasound2002;30:59-67.
26. Shanmuganathan K, Mirvis SE, Sherbourne CD, et al. Hemoperitoneum as thesole indicator of abdominal visceral injuries: a potential limitation of screeningabdominal US for trauma. Radiology1999;212:423-30.
27. Fagelman D, Hertz MA, Ross AS. Delayed development of splenic subcapsularhematoma: CT evaluation. J Comput Assist Tomogr1985;9:815-6.
28. Gamblin TC, Wall CE Jr, Royer GM, et al. Delayed splenic rupture: case reportsand review of the literature. J Trauma2005;59:1231-4.
29. Li YK, Zhou XD, Zhang J, et al. Contrastenhanced ultrasonography forevaluation of blunt hepatic trauma with active bleeding. Chin J Ultrason2005;14:618-20.
30. Spinazzi A. Emerging clinical applications for contrast-enhanced ultrasonography.Eur Radiol2001;11:E7-12.
31. Catalano O, Lobianco R, Raso MM, et al. Blunt hepatic trauma: Evaluation with
contrast-enhanced sonography: Sonographic findings and clinical application. J
Ultrasound Med2005;24:299-310.
2.裘法祖，主编,外科学.第四版.北京：人民卫生出版社,1996: p.409.
3. George D. Zuidema, R.B.R., Walter F. Ballinger, The Management ofTrauma,3rd ed. Philadelphia: WB Saunders Company,1999: p.459-459.
4. Parithivel, V.S., et al., Delayed presentation of splenic injury: still a commonsyndrome. Int Surg,2002.87(2): p.120-4.
5.杨春明，李纪仑,延迟性脾破裂的诊治问题（附17例报告）.实用外科杂志,1986.6（8）: p.411-412.
6. Lorimer, W.S., Jr., Occult Rupture of the Spleen. Arch Surg,1964.89: p.434-40.
7. Spacek, V., P. Jandik, and K. Smejkal, Delayed splenic rupture: an unusualcause of acute surgical abdomen. Acta Medica (Hradec Kralove),2002.45(1):p.45-6.
8. Burd, R.S. and M.A. Helikson, Delayed splenic rupture following low impactactivity. J Pediatr Surg,2000.35(10): p.1529.
9. Deva, A.K. and J.F. Thompson, Delayed rupture of the spleen51/2years afterconservative management of traumatic splenic injury. Aust N Z J Surg,1996.66(7): p.494-5.
10. Nast-Kolb, D., H.J. Bail, and G. Taeger,[Current diagnostics forintra-abdominal trauma]. Chirurg,2005.76(10): p.919-26.
11. Porter, R.S., et al., Use of ultrasound to determine need for laparotomy intrauma patients. Ann Emerg Med,1997.29(3): p.323-30.
12. Scalea, T.M., et al., Focused Assessment with Sonography for Trauma (FAST):results from an international consensus conference. J Trauma,1999.46(3): p.466-72.
13. Poletti, P.A., et al., Blunt abdominal trauma: should US be used to detect bothfree fluid and organ injuries? Radiology,2003.227(1): p.95-103.
14. Siniluoto, T.M., et al., Ultrasonography in traumatic splenic rupture. ClinRadiol,1992.46(6): p.391-6.
15. Minarik, L., et al., Diagnostic imaging in the follow-up of nonoperativemanagement of splenic trauma in children. Pediatr Surg Int,2002.18(5-6): p.429-31.
16. Catalano, O., et al., Active abdominal bleeding: contrast-enhanced sonography.Abdom Imaging,2006.31(1): p.9-16.
17. Miele, V., et al., Contrast enhanced ultrasound with second generation contrastagent in traumatic liver lesions. Radiol Med,2004.108(1-2): p.82-91.
18. Oakes, D.D. and A.C. Charters, Changing concepts in the management ofsplenic trauma. Surg Gynecol Obstet,1981.153(2): p.181-5.
19. Buntain, W.L. and H.R. Gould, Splenic trauma in children and techniques ofsplenic salvage. World J Surg,1985.9(3): p.398-409.
20.刘唐彬,小儿血液科与脾外科：附119例分析.实用外科杂志,1986.8: p.413-414.
21. Krivit, W., Overwhelming postsplenectomy infection. Am J Hematol,1977.2(2): p.193-201.
22. Upadhyaya P, S.J., Splenic trauma in children. Surg Gynecol Obstet,1968.126(4): p.781-190.
23. Upadhyaya, P., N.C. Nayak, and S. Moitra, Experimental study of splenictrauma in monkeys. J Pediatr Surg,1971.6(6): p.767-73.
24.夏穗生,我国脾脏外科的发展回顾.中国实用外科杂志,2004.24（12）: p.705-707.
25.乔海泉，代文杰，刘冰等,脾损伤的脾保留手术10年经验总结.中华肝胆外科杂志,2002.8(6): p.34.
26. Stein, D.M. and T.M. Scalea, Nonoperative management of spleen and liverinjuries. J Intensive Care Med,2006.21(5): p.296-304.
27.谭敏，辻羲彦，吴志棉，等,腹腔镜技术在脾切除术中的应用.中华外科杂志,2001.39(8): p.599-601.
28.祝智军，李大伟，郑蓉蓉,手助腹腔镜脾切除术治疗外伤性脾破裂.中华创伤杂志,2003.19(10): p.583-584.
29.张耘，宋建宁，宋林学，等,腹腔镜切除治疗外伤性脾破裂.中国微创外科杂志,2005.11: p.886-887.
30. Hagiwara, A., et al., Nonsurgical management of patients with blunt splenicinjury: efficacy of transcatheter arterial embolization. AJR Am J Roentgenol,
1996.167(1): p.159-66.
31.徐迎讯,脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察[J/CD].中华普通外科学文献：电子版,2007.1(4): p.228-229.
32.陆永良，韩春蕃，吴平，郑少俊，顾凤元,脾动脉栓塞止血治疗外伤性脾破裂.中华外科杂志,1997.35(1): p.31-32.
33.刘强，李铎，李建新，等,选择性脾动脉栓塞与脾修补术治疗外伤性脾破裂的比较.中华肝胆外科杂志,2005.11(11): p.752-754.
34.鞠新华，赵海英，于宏，等,微波在保脾手术中的临床应用（附5例报告）.肝胆外科杂志,2003.11（1）: p.57-58.
35. Tabuse, K., Basic knowledge of a microwave tissue coagulator and its clinicalapplications. J Hepatobiliary Pancreat Surg,1998.5(2): p.165-72.
36.吕发勤，唐杰，张惠琴，等.超声造影引导经皮注射治疗严重脾破裂出血.中华超声影像学杂志,2008.17(7): p.598-600.
37. Neveleff, D.J., L.W. Kraiss, and C.S. Schulman, Implementing methods toimprove perioperative hemostasis in the surgical and trauma settings. AORN J,
2010.92(5): p. S1-15.
38. Sarfati MR, D.D., Kraiss LW, Galt SW, Severe coagulopathy followingintraoperative use of topical thrombin. Ann Vasc Surg,2004.18(3): p.349-351.
39. Tomizawa, Y., Clinical benefits and risk analysis of topical hemostats: areview. J Artif Organs,2005.8(3): p.137-42.
40. Low RK, M.M., Goodnight JE Microfibrillar collagen hemostat duringlaparoscopically derected liver biopsy. J Laparoendosc Surg,1993.3: p.415-420.
41.邹勇，黄雅钦，夏宇正,明胶与天然聚合物复合制备创伤下敷料的研究进展.功能材料,2004.35: p.2310-2313.
42. Foster, R.P., Delayed haemorrhage from the ruptured spleen. Br J Surg,1970.57(3): p.189-92.
43. Benjamin, C.I., L.H. Engrav, and J.F. Perry, Jr., Delayed rupture or delayeddiagnosis of rupture of the spleen. Surg Gynecol Obstet,1976.142(2): p.171-2.
44.李正,董秀珍,尤富生,等家兔腹内出血动物模型的建立.中国比较医学杂志,2006.16(4)(217-219).
45. Buntain, W.L., H.R. Gould, and K.I. Maull, Predictability of splenic salvageby computed tomography. J Trauma,1988.28(1): p.24-34.
46. Spencer, D.D. and J.J. Ragland, Delayed splenic rupture: an unusual cause ofthe acute surgical abdomen. J Am Osteopath Assoc,1993.93(2): p.249-51.
47. Fitoz, S., et al., Post-traumatic intrasplenic pseudoaneurysms with delayedrupture: color Doppler sonographic and CT findings. J Clin Ultrasound,2001.29(2): p.102-4.
48. Lencioni, R., D. Cioni, and C. Bartolozzi, Tissue harmonic andcontrast-specific imaging: back to gray scale in ultrasound. Eur Radiol,2002.12(1): p.151-65.
49. Phillips, P. and E. Gardner, Contrast-agent detection and quantification. EurRadiol,2004.14Suppl8: p. P4-10.
50. Blaivas, M., et al., Tissue harmonic imaging improves organ visualization intrauma ultrasound when compared with standard ultrasound mode. AcadEmerg Med,2002.9(1): p.48-53.
51. McGahan, J.P., et al., Appearance of solid organ injury with contrast-enhancedsonography in blunt abdominal trauma: preliminary experience. AJR Am JRoentgenol,2006.187(3): p.658-66.
52. Catalano, O., et al., Blunt hepatic trauma: evaluation with contrast-enhancedsonography: sonographic findings and clinical application. J Ultrasound Med,
2005.24(3): p.299-310.
53.梁峭嵘,梁彤,黄春燕,等,超声造影在肝脏外伤鉴别诊断中的应用价值中国超声医学志,2006.22(10): p.760-763.
54. Catalano, O., et al., Real-time, contrast-enhanced sonography: a new tool fordetecting active bleeding. J Trauma,2005.59(4): p.933-9.
55. Amendola, M.A. and D. Nunez, Unenhanced CT scans in identifyinghematomas after blunt abdominal trauma. AJR Am J Roentgenol,1995.165(6): p.1544-5.
56.潘贤,新编药物实用全书北京:中国中医药出版社,1998: p.694-695.
57.朱明炜,曹金铎,贾振庚,等,蛇毒血凝酶在腹部手术中止血作用以及对凝血功能的影响中华外科杂志,2002.40(8): p.581-584.
58.李小敏,窦晓晖,王燕群立止血局部注射在耳鼻咽喉科出血中的应用.广东药学院学报,2005.21(1)(107-110).
59.毛巧云,陈雪英,立止血的临床应用与观察体会.海峡药学,2000.12(3): p.96-97.
60. Mankad, P.S. and M. Codispoti, The role of fibrin sealants in hemostasis. AmJ Surg,2001.182(2Suppl): p.21S-28S.
61. Schips, L., et al., Autologous fibrin glue using the Vivostat system forhemostasis in laparoscopic partial nephrectomy. Eur Urol,2006.50(4): p.801-5.
62. Shen, H.B., et al., Clinical application of laparoscopic spleen-preservingoperation in traumatic spleen rupture. Chin J Traumatol,2005.8(5): p.293-6.
63. Landegren, T., et al., Long-term results of peripheral nerve repair: acomparison of nerve anastomosis with ethyl-cyanoacrylate and epineuralsutures. Scand J Plast Reconstr Surg Hand Surg,2006.40(2): p.65-72.
64. Moretti Neto, R.T., et al., In vivo qualitative analysis of the biocompatibilityof different cyanoacrylate-based adhesives. Braz Oral Res,2008.22(1): p.43-7.
65. Kameda, N., et al., Management of gastric fundal varices without gastro-renalshunt in15patients. World J Gastroenterol,2008.14(3): p.448-53.
66. Fortelny, R.H., et al., Cyanoacrylate tissue sealant impairs tissue integration ofmacroporous mesh in experimental hernia repair. Surg Endosc,2007.21(10):p.1781-5.
67. Biggs, G., et al., Treatment of splenic injury during laparoscopic nephrectomywith BioGlue, a surgical adhesive. Urology,2005.66(4): p.882.
68. Kim, B.Y., et al., Microvascular anastomosis using cyanoacrylate adhesives. JReconstr Microsurg,2004.20(4): p.317-21.
69. Fotiadis, C., et al., The use of isobutylcyanoacrylate as a tissue adhesive inabdominal surgery. Acta Chir Belg,2005.105(4): p.392-6.
70.刘万章,张在新, α-氰基丙烯酸酯瞬间胶粘剂的现状和展望.中国胶粘剂,
2007.16(2): p.41-44.
71. Smith, J.S., Jr., R.N. Cooney, and P. Mucha, Jr., Nonoperative management ofthe ruptured spleen: a revalidation of criteria. Surgery,1996.120(4): p.745-50;discussion750-1.
72. Heuer, M., et al., No further incidence of sepsis after splenectomy for severetrauma: a multi-institutional experience of The trauma registry of the DGUwith1,630patients. Eur J Med Res,2010.15(6): p.258-65.
73. Sharma, O.P., et al., Assessment of nonoperative management of blunt spleenand liver trauma. Am Surg,2005.71(5): p.379-86.
74. Goffette, P.P. and P.F. Laterre, Traumatic injuries: imaging and intervention inpost-traumatic complications (delayed intervention). Eur Radiol,2002.12(5):p.994-1021.
75. Lau, H., Fibrin sealant versus mechanical stapling for mesh fixation duringendoscopic extraperitoneal inguinal hernioplasty: a randomized prospectivetrial. Ann Surg,2005.242(5): p.670-5.
76. Noh, D.Y., et al.,[Therapeutic effect of the endoscopicN-butyl-2-cyanoacrylate injection for acute esophagogastric variceal bleeding:comparison with transjugular intrahepatic portosystemic shunt]. Korean JGastroenterol,2004.43(3): p.186-95.
77. Thorelius, L., Contrast-enhanced ultrasound for extrahepatic lesions:preliminary experience. Eur J Radiol,2004.51Suppl: p. S31-8.
78. Xie, H., et al., Concentrated albumin as a biological glue for hemorrhagecontrol on hepatic resection with argon beam coagulation. J Biomed MaterRes B Appl Biomater,2004.71(1): p.84-9.
79. Koide, M., et al., A new type of biomaterial for artificial skin:dehydrothermally cross-linked composites of fibrillar and denatured collagens.J Biomed Mater Res,1993.27(1): p.79-87.
80. Stanton JS, S.V., Bentley G, et al, The growth of chondrocytes usinggelfoam(R) as a biodegradable scaffold.. J Mater Sci—Mater Med,1995.6: p.739–744.
81. JE., F., Adv Enzymol,1983.54: p.2-56.
82. Dube M, S.C., Neidhart S, et al.,. Reinhold Carle Eur Food Res Techno,2007.225: p.287-299.
83. JE, F., Transglutaminases. Biochemistry,1980.49: p.517-531.
84. Falcone P, S.D., Del Duca S Comparative studies of transglutaminaseactivity and substrates in different organs of helianthus tuverosus. PlantPhysiol,1993.142(): p.263-273.
85. Yasueda H, K.Y., Motoki M Purification and characterization of atissue-type transglutaminase from red sea bream. Bioscience BiotechnologyBiochemistry,1994.58: p.2041-2045.
86. Yasueda, H., Y. Kumazawa, and M. Motoki, Purification and characterizationof a tissue-type transglutaminase from red sea bream (Pagrus major). BiosciBiotechnol Biochem,1994.58(11): p.2041-5.
87.贺雷雨，李新华，王璋,谷氨酰胺转胺酶及其在食品加工中的应用.中国食物与营养,2004.4: p.22-24.
88. Lv, F., et al., Hemostatic agents injected directly into hepatic injury sites forliver trauma hemorrhage under the guidance of contrast-enhanced ultrasound:an animal experiment. Ultrasound Med Biol,2008.34(10): p.1604-9.
89. Tang, J., et al., Contrast-enhanced sonographic guidance for local injection ofa hemostatic agent for management of blunt hepatic hemorrhage: a caninestudy. AJR Am J Roentgenol,2008.191(3): p. W107-11.
90. Tang, J., et al., Comparison of gray-scale contrast-enhanced ultrasonographywith contrast-enhanced computed tomography in different grading of blunthepatic and splenic trauma: an animal experiment. Ultrasound Med Biol,2009.35(4): p.566-75.
91. Desai, P.J., et al., Hand-assisted laparoscopic partial nephrectomy in theporcine model using gelatin matrix hemostatic sealant without hilar occlusion.J Endourol,2005.19(5): p.566-9.
92. Gill, I.S., et al., Improved hemostasis during laparoscopic partial nephrectomyusing gelatin matrix thrombin sealant. Urology,2005.65(3): p.463-6.
93. Hick, E.J., et al., Gelatin matrix treatment of complex renal injuries in aporcine model. J Urol,2005.173(5): p.1801-4.
94. Klemcke, H.G., Evaluation of FloSeal as a potential intracavitary hemostaticagent. J Trauma,2006.60(2): p.385-9.
95. Leixnering, M., et al., Gelatin thrombin granules for hemostasis in a severetraumatic liver and spleen rupture model in swine. J Trauma,2008.64(2): p.456-61.
96. Baumann, A. and M. Caversaccio, Hemostasis in endoscopic sinus surgeryusing a specific gelatin-thrombin based agent (FloSeal). Rhinology,2003.41(4): p.244-9.
97. Lee, D.I., et al., Sealing percutaneous nephrolithotomy tracts with gelatinmatrix hemostatic sealant: initial clinical use. J Urol,2004.171(2Pt1): p.575-8.
98. Richter, F., et al., Improvement of hemostasis in open and laparoscopicallyperformed partial nephrectomy using a gelatin matrix-thrombin tissue sealant(FloSeal). Urology,2003.61(1): p.73-7.
1Georged Zuidema. The management of trauma,3th ed．Philadelphia:WBSaunders Company,1999,458-459.
2Vellore S. Parithivel Sai B. Sajja, Amit Basu, Moshe Schein. Delayedpresentation of spleen injury: still a common syndrome. Int Surg,2002,87(2):120-124
3陈维鹏，脾外科学，山东：山东科学技术出版社，1989：108-11
4杨春明，李纪仑.延迟性脾破裂的诊治问题（附17例报告）.实用外科杂志，1986，6（8）：411-412．
5Lorimer WS Jr．Occult rupture of the spleen.Arch Surg,1964,89:434-440
6Spacek V, Jandik P, Smejkal K. Delayed splenic rupture: an unusual cause ofacute surgical abdomen. Acta Medica,2002,45(1):45-46.
7Burd RS, Helikson MA. Delayed splenic rupture following low impact activity. JPediatr Surg,2000,35(10):1529.
8Deva AK, Thompson JF. Delayed rupture of the spleen5.5years afterconservative management of traumatic splenic injury. Aust N Z J Surg,1996,66(6):494-495.
9Simpson RA, Ajuwon R. Occult splenic injury: delayed presentation manifestingas jaundice. Emerg Med J,2001,18(6):504-505.
10Hammond JC, Canal DF, Broadie TA. Nonoperative management of adult blunthepatic trauma in municipal trauma center. Am Surg,1992，58(9):551-555.
11范康川，郭吉生，周惠彬，脾破裂延迟性出血.现代诊断与治疗，1992：（1）：29-30.
12FAST Consensus Conference Committee. Focused assessment with sonographyfor trauma (FAST): results from an international consensus conference. J Trauma,1999,46:466-4721.
13Poletti PA, Kinkel K, Vermeulen B, et al. Blunt abdominal trauma: should US beused to detect both free fluid and organ injuries? Radiology April,2003,227(1):95-103.
14李国杰，周永昌.急诊超声对钝性腹部创伤的内脏破裂出血的研究.中国超声医学杂志，2002，18（1）：29-33.
15Siniluoto TM, P iv nsalo MJ, Lanning FP, et al. Ultrasonography in traumaticspleen rupture. Clin Rediol,1992,46(6):391-396.
16吕发勤，唐杰，罗渝昆，李志艳，李俊来，黎檀实，超声造影在腹部实质脏器创伤快速分类治疗中的价值[J/CD].中华超声学杂志：电子版：2009：6（1）：25-29.
17Catalano O, Cusati B, Nunziata A, Siani A. Real-time, contrast-specificsonography imaging of acute splenic disorders: a pictorial review, Emerg Radiol,2004,11(1):15-21
18梁峭嵘，黄春燕，梁彤，等.超声造影在脾外伤评估分级诊断中的临床应用[J/CD]..中华超声医学杂志：电子版，2008：5（2）：288-294.
19Impellizzeri P, Cutrupi A, Chirico MR, et al．Conservative treatment of pediatricspleen trauma, Twenty years of experience． Pediatr Med Chir,2007,29(1):38-43.
20Jonas Rydberg, Kenneth A. Buckwalter, Karen S. Caldemeyer, Michael D.Phillps, Dewey J. Conces, Jr, Alex M. Aisen, Scott A. Persohn, Kenyon K.Kopecky, Multislicion CT: scanning techniques and clinicalapplications.Radiographics,2000,20(6):1787-1806.
21Becker CD, Spring P, Gl ttli A, et al. Blunt splenic trauma in adults: can CTfindings be used to determine the need for surgery? AJR Am JRoentgenol,1994,162(2):343-347
22夏穗生，我国脾脏外科的发展回顾.中国实用外科杂志，2004，24（12）：705-707
23范士志，蒋耀光，现代创伤治疗学.人民军医出版社，2009：334-336
24吕发勤，唐杰，张惠琴，等.超声造影引导经皮注射治疗严重脾破裂出血.中华超声影像学杂志，2008：17（7）：598-600.
25谭敏，辻羲彦，吴志棉，等.腹腔镜技术在脾切除术中的应用.中华外科杂志，2001，39（8）：599-601.
26祝智军，李大伟，郑蓉蓉.手助腹腔镜脾切除术治疗外伤性脾破裂.中华创伤杂志，2003，19（10）：583-584.
27张耘，宋建宁，宋林学，等.腹腔镜切除治疗外伤性脾破裂.中国微创外科杂志，2005，（11）：886-887.
28徐迎讯.脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察[J/CD].中华普通外科学文献：电子版，2007，1（4）：228-229.
29陆永良，韩春蕃，吴平，郑少俊，顾凤元，脾动脉栓塞止血治疗外伤性脾破裂，中华外科杂志，1997，35（1）：31-32.
30Hagiwara A, Yukioka T, Ohta S.Nonsurgical management of patients with bluntsplenic injury: efficacy of transcatheter arterial embolization. Am J Roentgenol,1996,167(1):159-166.
31刘强，李铎，李建新，等.选择性脾动脉栓塞与脾修补术治疗外伤性脾破裂的比较.中华肝胆外科杂志，2005，11（11）：752-754.
32鞠新华，赵海英，于宏，等.微波在保脾手术中的临床应用（附5例报告）.肝胆外科杂志，2003，11（1）：57-58.
33Tabuse K. Basic knowledge of a microwave tissue and its clinical applications. JHepatobiliary Pancreat Surg,1998,5(5):560-563.
34乔海泉，代文杰，刘冰，等.脾损伤的脾保留手术-10年经验总结.中华肝胆外科杂志，2002，8（6）：343-345.
35Moore EE, Cogbill TH，Jurkovich G J, et al.Organ injury scaling: spleen andliver (1994revision). J Trauma,1995,38(3):323-324.
36Federle MP, Jeffrey RB Jr. Hemoperitoneum studied by computed tomography.Radiology,1983,148(1):187-192.
37Godley CD, Warren RL, Sheridan RL, et al. Nonoperative management of bluntsplenic injury in adults: age over55years as a powerful indicator for failure. JAm Coll Surg,1996;183(2):133-139.
38Hawkins ML, Wynn JJ, Schmacht DC, et al. Nonoperative management of liverand/or splenic injuries: effect on resident surgical experience. Am Surg,1998,64(6):552-556.
39Goan YG, Huang MS, Lin JM. Nonoperative management for extensive hepaticand splenic injuries with significant henoperitoneum in adults. JTrauma,1998,45(2):360-364.
40张牧，姜洪池.保脾措施今日观.中国实用外科杂志，2009，29（5）：377-378.
41Richardson JD. Changes in the management of injuries to the liverand spleen. JAm Coll Surg,2005,200(5):648-669.
42李小敏,窦晓晖,王燕群.立止血局部注射在耳鼻咽喉科出血中的应用.广东药学院学报,2005;21(1):107-110.
43毛巧云,陈雪英.立止血的临床应用与观察体会.海峡药学,2000;12(3):96-97.
44潘贤,主编.新编药物实用全书.北京:中国中医药出版社,1998.695-695.
45朱明炜,朝金铎,贾振庚,等.蛇毒血凝酶在腹部手术中止血作用以及对凝血功能的影响.中华外科杂志,2002;40(8):581-584.
46Schip s L, Dalpiaz O, Cestari A, et al. Autologous fibrin glue using the vivostatsystem for hemostasis in laparoscopic partial nephrectomy. Eur Urol,2006;50(4):801-805.
47Suri A, Mehta VS, Sarkar C. Microneural anastomosis with fibrin glue: anexperimental study. Neurol India,2002;50(1):23-26Suri A, Mehta VS, Sarkar C.Microneural anastomosis with fibrin glue: an experimental study. Neurol India,2002;50(1):23-26
48Canby-Hagino ED, Morey AF, Jatoi I, et al. Fibrin sealant treatment of splenicinjury during open and laparoscopic left radical nephrectomy. J Urol,2000;164(6):2004-2005.
49Mankad PS, Codispoti M. The role of fibrin sealants in hemostasis. Am J Surg,2001;182(Suppl2):21S-28S
50Ellman PI, Brett Reece T, Maxey TS, et al. Evaluation of an absorbablecyanoacrylate adhesive as a suture line sealant. J Surg Res,2005;125(2):161-167.
51Shen HB, Lu XM, Zheng QC, et al. Clinical application of laparoscopic spleen-preserving operation in traumatic spleen rupture. Chin J Traumatol,2005;8(5):293-296.
52Landegren T, Risling M, Brage A, et al. Long-term results of peripheral nerverepair: a comparison of nerve anastomosis with ethyl-cyanoacrylate and epineuralsutures. Scand J Plast Reconstr Surg Hand Surg.2006;40(2):65-72.
53Moretti Neto RT, Mello I, Moretti AB, et al. In vivo qualitative analysis of thebiocompatibility of different cyanoacrylate-based adhesives. Braz Oral Res,2008;22(1):43-47.
54Kameda N, Higuchi K, Shiba M,et al. Management of gastric fundal variceswithout gastro-renal shunt in15patients. World J Gastroenterol,2008;14(3):448-453.
55Fortelny RH, Petter-Puchner AH, Walder N, et al. Cyanoacrylate tissue sealantimpairs tissue integration of macroporous mesh in experimental hernia repair.Surg Endosc,2007;21(10):1781-1785.
56Biggs G, Hafron J, Feliciano J, et al. Treatment of splenic injury duringlaparoscopic nephrectomy with BioGlue, a surgical adhesive. Urology,2005;66(4):882.
57Kim BY, Choi BH， Huh JY, et a1. Microvascular anastomosis usingcyanoacrylate adhesives. J Recormtr Microsurg,2004;20(4):317-321.
58Fotiadis C, Leventis I, Adamis S, et al. The use of isobutylcyanoacrylate as atissue adhesive in abdominal surgery. Acta Chir Belg,2005;105(4):392-396.
59刘万章,张在新. a-氰基丙烯酸酯瞬间胶粘剂的现状和展望.中国胶粘剂,2007;16(2):41-44.
60Georged Zuidema. The Management of Trauma,3rd ed． Philadelphia:WBSaunders Company,1999:458-459.
61Parithivel VS, Sajja SB, Basu A, et al. Delayed presentation of splenic injury: stilla common syndrome. Int Surg,2002,87(2):120-124
62陈维鹏，脾外科学，山东：山东科学技术出版社，1989：108-11
63杨春明，李纪仑.延迟性脾破裂的诊治问题（附17例报告）.实用外科杂志，1986，6（8）：411-412．
64Lorimer WS Jr．Occult rupture of the spleen.Arch Surg,1964,89:434-440
65Spacek V, Jandik P, Smejkal K. Delayed splenic rupture: an unusual cause ofacute surgical abdomen. Acta Medica,2002,45(1):45-46.
66Burd RS, Helikson MA. Delayed splenic rupture following low impact activity. JPediatr Surg,2000,35(10):1529.
67Deva AK, Thompson JF. Delayed rupture of the spleen5.5years afterconservative management of traumatic splenic injury. Aust N Z J Surg,1996,66(6):494-495.
68Simpson RA, Ajuwon R. Occult splenic injury: delayed presentation manifestingas jaundice. Emerg Med J,2001,18(6):504-505.
69Hammond JC, Canal DF, Broadie TA. Nonoperative management of adult blunthepatic trauma in municipal trauma center. Am Surg,1992，58(9):551-555.
70范康川，郭吉生，周惠彬，脾破裂延迟性出血.现代诊断与治疗，1992：3（1）：29-30.
71FAST Consensus Conference Committee. Focused assessment with sonographyfor trauma (FAST): results from an international consensus conference. J Trauma,1999,46:466-4721.
72Poletti PA, Kinkel K, Vermeulen B, et al. Blunt abdominal trauma: should US beused to detect both free fluid and organ injuries? Radiology April,2003,227(1):95-103.
73李国杰，周永昌.急诊超声对钝性腹部创伤的内脏破裂出血的研究.中国超声医学杂志，2002，18（1）：29-33.
74Siniluoto TM, P iv nsalo MJ, Lanning FP, et al. Ultrasonography in traumaticspleen rupture. Clin Rediol,1992,46(6):391-396.
75吕发勤，唐杰，罗渝昆，李志艳，李俊来，黎檀实，超声造影在腹部实质脏器创伤快速分类治疗中的价值[J/CD].中华超声学杂志：电子版：2009：6（1）：25-29.
76Catalano O, Cusati B, Nunziata A, Siani A. Real-time, contrast-specificsonography imaging of acute splenic disorders: a pictorial review, Emerg Radiol,2004,11(1):15-21
77梁峭嵘，黄春燕，梁彤，等.超声造影在脾外伤评估分级诊断中的临床应用[J/CD]..中华超声医学杂志：电子版，2008：5（2）：288-294.
78Impellizzeri P, Cutrupi A, Chirico MR, et al．Conservative treatment of pediatricspleen trauma, Twenty years of experience．Pediatr Med Chir,2007,29(1):38-43.
79Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanningtechniques and clinical applications. Radiographics,2000,20(6):1787-1806.
80Becker CD, Spring P, Gl ttli A, et al. Blunt splenic trauma in adults: can CTfindings be used to determine the need for surgery? AJR Am JRoentgenol,1994,162(2):343-347
81夏穗生，我国脾脏外科的发展回顾.中国实用外科杂志，2004，24（12）：705-707
82范士志，蒋耀光，现代创伤治疗学.人民军医出版社，2009：334-336
83吕发勤，唐杰，张惠琴，等.超声造影引导经皮注射治疗严重脾破裂出血.中华超声影像学杂志，2008：17（7）：598-600.
84谭敏，辻羲彦，吴志棉，等.腹腔镜技术在脾切除术中的应用.中华外科杂志，2001，39（8）：599-601.
85祝智军，李大伟，郑蓉蓉.手助腹腔镜脾切除术治疗外伤性脾破裂.中华创伤杂志，2003，19（10）：583-584.
86张耘，宋建宁，宋林学，等.腹腔镜切除治疗外伤性脾破裂.中国微创外科杂志，2005，（11）：886-887.
87徐迎讯.脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察[J/CD].中华普通外科学文献：电子版，2007，1（4）：228-229.
88陆永良，韩春蕃，吴平，郑少俊，顾凤元，脾动脉栓塞止血治疗外伤性脾破裂，中华外科杂志，1997，35（1）：31-32.
89Hagiwara A, Yukioka T, Ohta S.Nonsurgical management of patients with bluntsplenic injury: efficacy of transcatheter arterial embolization. Am J Roentgenol,1996,167(1):159-166.
90刘强，李铎，李建新，等.选择性脾动脉栓塞与脾修补术治疗外伤性脾破裂的比较.中华肝胆外科杂志，2005，11（11）：752-754.
91鞠新华，赵海英，于宏，等.微波在保脾手术中的临床应用（附5例报告）.肝胆外科杂志，2003，11（1）：57-58.
92Tabuse K. Basic knowledge of a microwave tissue and its clinical applications. JHepatobiliary Pancreat Surg,1998,5(5):560-563.
93乔海泉，代文杰，刘冰，等.脾损伤的脾保留手术-10年经验总结.中华肝胆外科杂志，2002，8（6）：343-345.
94Moore EE, Cogbill TH，Jurkovich G J, et al.Organ injury scaling: spleen andliver (1994revision). J Trauma,1995,38(3):323-324.
95Federle MP, Jeffrey RB Jr. Hemoperitoneum studied by computed tomography.Radiology,1983,148(1):187-192.
96Godley CD, Warren RL, Sheridan RL, et al. Nonoperative management of bluntsplenic injury in adults: age over55years as a powerful indicator for failure. JAm Coll Surg,1996;183(2):133-139.
97Hawkins ML, Wynn JJ, Schmacht DC, et al. Nonoperative management of liverand/or splenic injuries: effect on resident surgical experience. Am Surg,1998,64(6):552-556.
98Goan YG, Huang MS, Lin JM. Nonoperative management for extensive hepaticand splenic injuries with significant henoperitoneum in adults. JTrauma,1998,45(2):360-364.
99张牧，姜洪池.保脾措施今日观.中国实用外科杂志，2009，29（5）：377-378.
100Richardson JD. Changes in the management of injuries to the liverand spleen. JAm Coll Surg,2005,200(5):648-669.
1. Foster RP. Delayed haemorrhage from the ruptured spleen. Br J Surg1970;57:189-92.
2. Schwartz SI, Shires GT, Spencer FC. Principles of Surgery.5th ed. New York,NY: McGraw-Hill Book Company,1989:271-3.
3. Kluger Y, Paul DB, Raves JJ, et al. Delayed rupture of the spleen--myths, facts,and their importance: case reports and literature review. J Trauma1994;36:568-71.
4. Benjamin CI, Engrav LH, Perry JF Jr. Delayed rupture or delayed diagnosis ofrupture of the spleen. Surg Gynecol Obstet1976;142:171-2.
5. Berlatzky Y, Shiloni E, Anner H, et al."Delayed rupture of the spleen" ordelayed diagnosis of the splenic injury? Isr J Med Sci1980;16:659-64.
6. Cogbill TH, Moore EE, Jurkovich GJ, et al. Nonoperative management of bluntsplenic trauma: a multicenter experience. J Trauma1989;29:1312-7.
7. Richards JR, Schleper NH, Woo BD, et al. Sonographic assessment of bluntabdominal trauma: a4-year prospective study. J Clin Ultrasound2002;30:59-67.
8. Shanmuganathan K, Mirvis SE, Sherbourne CD, et al. Hemoperitoneum as thesole indicator of abdominal visceral injuries: a potential limitation of screeningabdominal US for trauma. Radiology1999;212:423-30.
9. Yoshii H, Sato M, Yamamoto S, et al. Usefulness and limitations ofultrasonography in the initial evaluation of blunt abdominal trauma. J Trauma1998;45:45-50.
10. Becker CD, Mentha G, Terrier F. Blunt abdominal trauma in adults: role of CT inthe diagnosis and management of visceral injuries. Part1: liver and spleen. EurRadiol1998;8:553-62.
11. Richards JR, Derlet RW. Computed tomography for blunt abdominal trauma inthe ED: a prospective study. Am J Emerg Med1998;16:338-42.
12. Xie H, Wolf RF, Burke AP, et al. Concentrated albumin as a biological glue forhemorrhage control on hepatic resection with argon beam coagulation. J BiomedMater Res B Appl Biomater2004;71:84-9.
13. Li Z, Dong XZ, You FS, et al. Establishment of animal model of intraperitonealbleeding in rabbits. Chin J Comparative Med2006;16:217-9.
14. Leen E, Angerson WJ, Yarmenitis S, et al. Multi-centre clinical study evaluatingthe efficacy of SonoVue (BR1), a new ultrasound contrast agent in Dopplerinvestigation of focal hepatic lesions. Eur J Radiol2002;41:200-6.
15. von Herbay A, Vogt C, Willers R, et al. Real-time imaging with the sonographiccontrast agent SonoVue: differentiation between benign and malignant hepaticlesions. J Ultrasound Med2004;23:1557-68.
16. Strobel D, Kleinecke C, H nsler J, et al. Contrast-enhanced sonography for thecharacterisation of hepatocellular carcinomas--correlation with histologicaldifferentiation. Ultraschall Med2005;26:270-6.
17. Albrecht T, Hohmann J, Oldenburg A, et al. Detection and characterisation ofliver metastases. Eur Radiol2004;14:P25-33.
18. Dang C, Schlater T, Bui H, et al. Delayed rupture of the spleen. Ann Emerg Med1990;19:399-403.
19. Zabinski EJ, Harkins HN. Delayed splenic rupture: A clinical syndromefollowing trauma. Arch Surg1943;46:186-212.
20. Sizer JS, Wayne E, Frederick PL. Delayed rupture of the spleen. Arch Surg1966;92:362-6.
21. Olsen WR, Polley TZ Jr. A second look at delayed splenic rupture. Arch Surg1977;112:422-5.
22. Farhat GA, Abdu RA, Vanek VW. Delayed splenic rupture: real or imaginary?Am Surg1992;58:340-5.
23. Scalea TM, Rodriguez A, Chiu WC, et al. Focused assessment with sonographyfor trauma (FAST): results from an international consensus conference. J Trauma1999;46:466-72.
24. Benya EC, Lim-Dunham JE, Landrum O, et al. Abdominal sonography inexamination of children with blunt abdominal trauma. AJR Am J Roentgenol2000;174:1613-6.
25. Richards JR, Schleper NH, Woo BD, et al. Sonographic assessment of bluntabdominal trauma: a4-year prospective study. J Clin Ultrasound2002;30:59-67.
26. Shanmuganathan K, Mirvis SE, Sherbourne CD, et al. Hemoperitoneum as thesole indicator of abdominal visceral injuries: a potential limitation of screeningabdominal US for trauma. Radiology1999;212:423-30.
27. Fagelman D, Hertz MA, Ross AS. Delayed development of splenic subcapsularhematoma: CT evaluation. J Comput Assist Tomogr1985;9:815-6.
28. Gamblin TC, Wall CE Jr, Royer GM, et al. Delayed splenic rupture: case reportsand review of the literature. J Trauma2005;59:1231-4.
29. Li YK, Zhou XD, Zhang J, et al. Contrastenhanced ultrasonography forevaluation of blunt hepatic trauma with active bleeding. Chin J Ultrason2005;14:618-20.
30. Spinazzi A. Emerging clinical applications for contrast-enhanced ultrasonography.Eur Radiol2001;11:E7-12.
31. Catalano O, Lobianco R, Raso MM, et al. Blunt hepatic trauma: Evaluation with
contrast-enhanced sonography: Sonographic findings and clinical application. J
Ultrasound Med2005;24:299-310.