脾脓肿

Splenic abscess

目的 介绍脾脓肿的病因 ,发病机理 ,临床表现及诊治方法。方法 根据作者收治的 9例脾脓肿的临床资料 ,结合文献复习。结果 脾脓肿可分为尸检型和临床型。尸检发现率为 0 4%～0 7%。临床型以单发巨大脾脓肿多见。脾脓肿主要为血源性感染所致。早期临床表现无特殊性。血培养阳性率为 1 5 %～ 70 % ,影像学检查对诊断有帮助。本病误诊率高达 2 2 2 %～ 50 %。脾脓肿手术治疗效果好。结论 脾脓肿临床少见 ,术前诊断率低 ,易误诊漏诊。一经确诊 ,应及时手术治疗。

Objective To introduce the etiology, pathogenesis, clinical manifestation, diagnosis and treatment of splenic abscess(SA). Methods A sumarrization was made on the clinical data of 9 cases of SA who were treated by auther with leterature review. Results SA could be divided to autopsy type and clinical type, the demonstration rate of SA was 0.4%～0.7% in autopsy. Clinically massive solitary SA was common. The source of infection was mamily from blood stream. No special clinical manifestation was found in the early stage of SA. Possitive blood culture rate was 15%～70% in SA patients. Imagic examination was helpful to the diagnosis of SA. The misdiagnosis rate of SA was as high as 22.5%～50%, even more. Surgical treatment had good result. Conclusions Clinically SA is less common. The misdiagnosis rate of SA is high; once the diagnosis is made, surgical treatment should be given as soon as possible.