外伤性脾破裂92例诊治分析

Diagnostic and therapeutic analysis of traumatic splenic rupture in 92 cases

【目的】探讨并建立外伤性脾破裂的临床诊治规范。【方法】回顾性分析1997年1月—2004年12月诊治的92例外伤性脾破裂的临床诊疗资料。【结果】入院时明确诊断89例,误诊3例。保脾治疗53例,全部成功,保脾治疗率为57.6%。非手术治愈18例,手术治愈67例。死亡7例,病死率7.6%。【结论】外伤性脾破裂的诊断主要依据临床表现、诊断性腹腔穿刺和超声检查。保脾治疗占有重要地位,可根据病情选择适当治疗方法。

[Objective] To explore and establish the diagnostic and therapeutic standard of traumatic splenic rupture. [Methods] The clinical data of 92 patients with traumatic splenic rupture admitted from January, 1997 to December, 2004 were retrospectively analyzed. [ Results] There were 89 patients with identified diagnosis on admission. 3 cases were misdiagnosed. In all patients, 53 cases were treated for preserving spleen and they were all success. The rate of preserving spleen therapy was 57.6%. 18 eases were cured by non-operative therapy and 67 cases were cured by operative therapy. 7 cases died. The case fatality was 7.6%. [Conclusion] The diagnosis of traumatic splenic rupture was mainly depended on clinical symptoms, diagnostic abdominal paracentesis and sonography. Treatment of preserving spleen played an important role in the management of traumatic splenic rupture. Suitable therapeutic methods should be selected according to different cases.