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文献考察：1991-1998年の脾損傷222例と1998-2005年の403例を比較して，保存的治療は61%→85％，脾動脈塞栓術は2.7%→22.6%，保存的治療の成功率は77%→96%，脾臓温存率は57%→88%，死亡率は12%→6%，入院日数は15日→9日に短縮し，著しく改善した．
Surgery. 2006 Oct;140(4):625-31; discussion 631-2.
Improved outcome of adult blunt splenic injury: a cohort analysis.
Rajani RR, Claridge JA, Yowler CJ, Patrick P, Wiant A, Summers JI, McDonald AA, Como JJ, Malangoni MA.
BACKGROUND: The purpose of this study was to review our 15-year experience in the treatment of blunt splenic injury in adults. Our hypothesis was that the implementation of a change in practice, with stress on splenic preservation and splenic artery embolization for the management of splenic injury, would result in improved splenic salvage rates without negatively affecting mortality rates. METHODS: A retrospective cohort analysis was performed on all consecutive adults with blunt splenic injury who were admitted to a Level One Trauma Center. The cohorts were defined by 2 separate 7.5-year periods (1991-1998 and 1998-2005). RESULTS: Six hundred twenty-five patients with blunt splenic trauma were identified; 403 patients who were treated from 1998 to 2005 were compared with 222 patients whose cases had been reviewed previously (1991 to 1998). The present cohort differed in age (35 vs 40 years; P
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