To explore the classification of splenic trauma and methods for treatment selection.

Clinical data of 260 patients with splenic trauma admitted to the First People's Hospital of Chenzhou from January 2020 to January 2025 were analyzed retrospectively. Among them, 188 patients were male and 72 female, aged from 2 to 75 years, with a median age of 39 years. Among 188 patients, 161 cases experienced traffic accident injuries, 48 cases of falling injuries, 12 cases of stab injuries and 39 cases of blunt injuries. 69 patients were diagnosed with splenic rupture alone, 163 cases of spleen rupture complicated with brain trauma, multiple fractures, chest trauma and other extraperitoneal organ injuries, 16 cases of splenic rupture complicated with liver rupture, 8 cases of splenic rupture complicated with pancreatic rupture and 4 cases of splenic rupture complicated with gastrointestinal perforation. The splenic trauma was graded to the grading standards of splenic injury of Chinese Medical Association, according to the grading, kinetic energy of patients' injury, the changes of vital signs after injury and the involved organs, the diagnosis and treatment regimens for splenic trauma were formulated. Treatment methods included conservative treatment, interventional treatment, laparoscopic and open splenectomy, etc. For those complicated with other organ injuries, corresponding surgery or conservative treatments were performed.

Twelve patients were assessed as grade Ⅰ, 24 cases of grade Ⅱ, 159 cases of grade Ⅲ and 65 cases of grade Ⅳ, respectively. The success rate of treatment for splenic trauma was 98.8%(257/260), including 226 cases of surgery, 32 cases of conservative treatment and 2 cases of interventional treatment. Surgical methods included splenectomy combined with splenic tissue autotransplantation in 191 cases, partial splenectomy in 3 cases, laparoscopic splenectomy in 29 cases and laparoscopic partial splenectomy in 3 cases, respectively. 16 patients complicated with liver rupture were simultaneously treated with partial hepatectomy and repair of liver rupture, 8 cases complicated with pancreatic rupture were simultaneously treated with partial pancreatectomy and repair, and 4 cases complicated with gastrointestinal perforation were simultaneously treated with gastrointestinal repair.

The diagnosis and treatment regimen of splenic trauma should be formulated based on the grading, kinetic energy of splenic injury, the changes of patients' vital signs after injury and the involved organs, and appropriate treatment methods should be adopted. Splenectomy is the most effective treatment for emergent patients.