[目的]探讨急诊腹腔镜脾切除术(LS)治疗外伤性脾破裂患者的临床效果.[方法]回顾性分析本院收治的 82 例外伤性脾破裂患者临床资料,根据手术方法将其分为观察组(行 LS术,n ＝43)和对照组(行剖腹探查及全脾切除术,n＝39).比较两组手术时间、术中出血量、术后排气时间、住院时间及并发症.比较两组术前、术后 3 d外周白细胞计数(WBC)、白细胞介素6(IL6)、皮质醇(Cor)、肿瘤坏死因子α(TNFα)水平.[结果]观察组手术时间长于对照组,术后排气时间、平均住院时间、术中出血量均小于对照组,差异有统计学意义(P ＜0.05).术后 3 d两组Cor、TNFα、IL6 水平均高于术前,对照组术后3 d时WBC水平高于术前,差异均有统计学意义(P ＜0.05);观察组术后 3 d时 Cor、TNFα、IL6、WBC水平均低于对照组,差异均有统计学意义(P ＜0.05).观察组并发症发生率为 6.98%(3／43)低于对照组的 23.08%(9／39),差异有统计学意义(χ2＝－6.270,P ＜0.05).[结论]外伤性脾破裂患者行 LS术创伤小,并发症少,应激和炎性反应轻,术后恢复快,值得临床推广应用.“,”[Objective]To explore the clinical effect of emergency laparoscopic splenectomy (LS)in the treatment of traumatic splenic rupture.[Methods]The clinical data of 82 patients with traumatic splenic rupture in our hospital were analyzed retrospectively.According to the operation method,they were divided into two groups:the observation group (LS operation,n＝43)and the control group (exploratory laparotomy and total splenectomy,n＝39).The operation time,intraoperative hemorrhage,postoperative exhaust time,hospitalization time and complications were compared between the two groups.The levels of WBC,IL6,cor and TNFα were compared before and 3 days after operation.[Results]The operation time of the observation group was longer than that of the control group,and the postoperative exhaust time,average hospitalization time and intraoperative bleeding volume of the observation group were less than those of the control group (P＜0.05).The level of Cor,TNFα,IL6 water in the two groups was higher than that before operation on the 3rd day after operation,and the WBC level in the control group was higher than that before operation on the 3rd day after operation,the difference was statistically significant (P ＜0.05);the level of Cor,TNFα,IL6,WBC in the observation group was lower than that in the control group on the 3rd day after operation,the difference was statistically significant (P＜0.05).The incidence of complications in the observation group was 6.98%(3／43)lower than that in the control group 23.08%(9／39),the difference was statistically significant (χ2＝－6.270,P ＜0.05).[Conclusion]Patients with traumatic splenic rupture after LS have less trauma,less complications,less stress and inflammatory response,and quick recovery,which is worthy of clinical application.