摘要
目的:探讨外伤性延迟性脾破裂的发病规律、临床特点、诊断和治疗方法。方法:结合国内外资料及本组病例进行回顾分析。结果:明确诊断13例,误诊为肝破裂1例,腹膜后血肿1例,肾挫裂伤1例,宫外孕破裂1例。16例手术治疗,1例非手术治疗。行脾切除术10例,其中保留副脾1例,脾切除加自体脾组织网膜内移植术1例,脾缝合修补术3例;脾部分切除术3例。治愈16例,死亡1例。结论:本病由于腹腔内出血与受伤时间间隔长,容易误诊。诊断除依靠病史、临床表现外,应及时进行腹腔穿刺、B超及CT检查。治疗以脾切除为主,可根据病情、脾破裂的程度以及是否有合并伤等情况采取保脾手术或非手术治疗。
Objective： To study the diagnosis and treatment of traumatic delayed rupture of spleen. Methods： Clinical data of 17 patients with traumatic delayed rupture of spleen were retrospectively analysed. Results： Preoperative diagnosis of 13 patients were clear-out,misdiagnosis was as rupture of liver for 1 patient, as post-peritonem hematoma for 1 patient,as Kidney contusion for 1 patient,as ectopic pregnancy for 1 patient. 16 cases underwent operation, 1 patient was treated without surgery. Of the 16 patients who had surgery, 10 patients had splenectomy, 1 case reserved accessory spleen, 1 case had splenectomy pulsing self splenosis into omentum; 3 patients had spleen sutured; 3 patients had spleen partial splenectomy. 16 patients were cured, 1 patient died. Conclusion：The disease is easily to misdiagnosis owing to a long time lag between the injury and intraabdominal hemorrhage. Besides the history and clinical manitestation, peritoneal puncture, sonograpby computed tomography were needed to make a diagnosis. Splenectomy is a primary way for treatment, but operative preservation of the spleen and nonsurgery should be considered according to the state of illness,degree of the rupture of spleen.
出处
《中国临床医学》
北大核心
2005年第4期627-628,共2页
Chinese Journal of Clinical Medicine
关键词
延迟性脾破裂
诊断
治疗
脾切除
Delayed rupture of spleen
Diagnosis
Treatment
Splenectomy
