外伤性延迟性脾破裂11例诊断与治疗

Diagnosis and Treatment of Traumatic Delayed Rupture of Spleen:report of 11 cases

目的探讨外伤性延迟性脾破裂的临床特点、诊断和治疗方法。方法回顾性分析我院自2000年12月至2005年12月收治的11例外伤性延迟性脾破裂病例的临床特点、诊断和治疗结果。结果明确诊断7例,误诊为肝破裂3例、宫外孕出血1例。11例病人均行手术治疗,其中行脾切除8例,脾部分切除术2例;术中死亡1例。结论本病由于受伤间隔时间长,腹腔内出血症状隐匿,故误诊率高(本组误诊率36%)。诊断依靠询问病史、临床表现,及时进行腹腔穿刺、B超及CT检查,治疗以脾切除术为主。

Objective To investigate the clinical characteristic, diagnosis and treatment of delayed rupture of spleen. Methods Retrospective analysis 11 patients, to investigate their clinical characteristic, diagnosis and treatment of delayed rupture of spleen. Results 7 patients were diagnosis, 3 cases were misdiagnosis as rupture of liver, 1 patient as ectopic pregnancy. All of 11 cases were undergone operation, 8 patients had splenectom .2 patient had spleen partial splenectomy .1 patient died during the operation. Conclusion The disease is easily misdiagnosis owing to an long intermission after injury, and the symtom of intraabdominal hemorrhage are conceal （misdiagnosis rate 36%）. diagnosis of the disease depend on the ease history and clinical situation,peritoneal puncture ,sonograpby and computed tomography. Splenectomy is primary way for treatment,