延迟性脾破裂的诊断和治疗

Diagnosis and treatment of delayed rupture of spleen

目的探讨延迟性脾破裂(delayed rupture of spleen,DRS)的诊断与治疗,以提高对DRS的认识,避免误诊、误治。方法回顾性分析我院自1997年1月至2007年12月收治的21例DRS的临床资料。结果本组有20例接受了外科手术治疗,其中行脾切除术14例,行脾脏部分切除术6例。本组除1例(4.8%)因失血性休克而死亡,后经尸检解剖证实为脾破裂外,均已完全康复。结论增强对的DRS认识,掌握其临床特点,做到早期诊断和及时的外科手术治疗,对提高DRS的治愈率,减少误诊、误治十分重要。

Objective To explore the diagnosis and therapy of delayed rupture of spleen（DRS）, improve us better understand DRS, and avoid misdiagnosis and incorrect treatment. Methods The clinical data of 21 cases with DRS from January 1997 to December 2007 in our hospital were analyzed retrospectively. Results Among the 21 cases of DRS, there were 20 patients undergoing surgical operations, including 14 cases of splenectomy and 6 cases of partial splenectomy, and then, all these pa- tients had recovered. The mortality was 4. 8 %（1 case）for the DRS patients. The major cause for death was hemorrhagic shock, which was confirmed as splenic rupture when the patient was necroscopied. Conclusion For the purpose of increasing the curative rate and reducing the misdiagnosis and incorrect treatment of DRS, taking hold of its features, raising the vigilance of discerning DRS, making an early correct diagnosis, and the timely surgical operations are of great importance.