摘要
目的探讨非外伤性腹膜后血肿(RPH)的临床特点并进行文献分析,以提高对该病的认识。方法回顾性分析北京大学第一医院2000年1月至2013年1月诊治的8例非外伤性RPH患者的临床资料,对其临床表现、辅助检查、治疗及转归情况进行总结分析。结果 8例患者中男4例,女4例;中位年龄74岁。4例出现在股动脉穿刺介入治疗后,3例在股静脉穿刺后,1例在肾癌术后2周透析治疗过程中。7例患者出现腹痛,腹部可触及包块,伴压痛。4例患者伴有血压明显下降。所有患者均有血红蛋白下降,下降最高达90 g/L。所有病例均进行了床旁B超检查,可见腹膜后大小不等囊实性或囊性包块。所有患者都给予了保守治疗,5例患者好转,3例患者当日死亡。结论非外伤性RPH临床表现缺乏特异性,病死率高,腹痛、血红蛋白下降和腹部痛性包块是常见的临床表现,动静脉血管穿刺、抗栓治疗可能是RPH的危险因素,需提高警惕。
Objective T,o investigate the clinical characteristics of non-traumatic retroperitoneal hematoma （RPH）. Meth- ods The clinical manifestations and laboratory data of 8 cases of non-traumatic retroperitoneal hematoma were analyzed ret-rospectively. Results There were 4 males and 4 females with an median age of 74 years old. 4 patients were resulted from femoral artery puncture angiography in interventional therapy ,3 patients from femoral vein puncture, and one occurred dur-ing dialysis 2 weeks after operation for renal eell carcinoma. 7 patients had abdominal pain, abdominal mass with tender-ness. 4 patients had obvious blood pressure drop. Almost all patients had a hemoglobin decrease, with the highest 90 g/L. All patients received bedside B ultrasound examination, which revealed retroperitoneal cystic and solid or cystic masses of differ-ent sizes. All patients were treated conservatively,6 patients received blood transfusion. 5 patients recovered,3 patients died of shock on the very day of RPH. Conclusion RPH is uncommon but potentially lethal, with a non-specific presentation that can lead to misdiagnosis. The most common symptom was abdominal pain, decreased hemoglobin and abdominal mass with tenderness. Vascular puncture, antithrombotic therapy were risk factors for RPH, which needs to be alerted.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2013年第9期735-737,共3页
Chinese Journal of Practical Internal Medicine
关键词
血肿
腹膜后间隙
股动脉穿刺
股静脉置管
hematoma
retroperitoneal space
femoral artery puncture angiography
femoral vein puncture
