外伤性延迟性脾破裂临床实例分析

Clinical analysis for traumatic delayed rupture of spleen

关键词:  延迟性脾破裂  诊断  治疗  脾切除

Key words:  delayed rupture of spleen  diagnosis  treatment  splenectomy

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12例病例进行回顾分析。［结果］明确诊断10例，误诊为肝破裂1例，脾肿瘤 1例。12例均手术治疗。行脾切除术2例，脾切除加自体脾组织网膜内移植术9例，脾缝合修补加脾动脉结扎1例。12例均治愈。［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。

Abstract:

［Objective］To study the diagnosis and treatment of traumatic delayed rupture of spleen. ［Methods］　Clinical data of 12 patients with traumatic delayed rupture of spleen were retrospectively analysed．［Results］Preoperative diagnosis of 10 patients were clear-out，misdiagnosis was as rupture of liver for 1 patient，as Spleen Tumor for 1 patient．12 cases all underwent operation. Of the 12 patients who had surgery，2 patients had splenectomy， 9 cases had splenectomy pulsing self splenosis into omentum ；1 patienthad splen sutured and splenic arter ligated. 12 patients were all cured．［Conclusion］ The disease is easily to misdiagnosis owing to an long time lag between the injury and intraabdominal hemorhage．Besides the case history and clinical situation，peritoneal puncture，sonography，CT were needed to make a diagnosis．Splenectomy is primary way for treatment，but operative preservation of the spleen should be considered according to the state of an illness，degree of the rupture of spleen and associated injury and so on．