自发性腹腔内出血的诊断与治

Diagnosis and treatment of spontaneous abdominal hemorrhage

目的提高对自发性腹腔内出血的认识。方法回顾我院自 1976年以来 8例自发性腹腔内出血，并结合文献进行讨论。结果 8例中发生于高血压 5例，肝硬化、门脉高压症 2例，原因不明 1例。出血部位在肠系膜上动脉 3例，胃左动脉 1例，副脐静脉 1例，出血部位不明 3例。结论自发性腹腔内出血，术前诊断较困难，腹腔穿刺对本病的诊断与其它急腹症鉴别极有帮助，手术结扎破裂之血管为治疗本病的有效措施。

Objective To increase the knowledge of spontaneous abdominal hemorrhage. Methods 8 cases of spontaneous abdominal hemorrhage treated from 1976 were presented with review of the literature. Results Of the 8 cases,3 were male and 5 were female.Age ranged from 17 to 78 years.The hemorrhagic causes included:hypertension in 5cases,hepatocirrhosis and portal hypertension in 2 cases,and unknown reason in 1case.The hemorrhagic points were at arteria mesenteric superior(3cases),arteria gastric sinistral(1 case),and vein paraumbilicales(1 case),the hemorrhagic points of the other 3 cases were unknown. Conclusion It is difficult to diagnose spontaneous abdominal hemorrhage before operation.But abdominal puncture can give much help to diagnose this disease and differentiate from acute abdomens.Ligating rupture vessels in operation is an effective method for treatment of the disease.