脾自发性破裂的诊断与治疗16例报道

Diagnosis and Treatment of Splenic Spontaneous Rupture: a report of 16 cases

目的 总结脾自发性破裂的临床诊断和治疗经验。方法 对我院 1995年 1月～ 2 0 0 2年 7月间收治的 16例脾自发性破裂患者的临床资料进行回顾性分析。结果 全组 16例患者中 ,脾囊肿 2例 ,脾血管瘤 4例 ,脾恶性肿瘤 10例。其中 14例行急诊剖腹探查 +全脾切除术 ,2例假性脾破裂行限期全脾切除术。脾恶性肿瘤的术后预后差 ,本组生存期 2个月～ 4年半 ,1例脾原发性恶性淋巴瘤Ⅰ期患者现已生存 4年半。结论 脾自发性破裂的病因复杂 ,术前病因诊断困难 ,且恶性肿瘤居多 ,临床上大多急诊行剖腹探查 +脾切除术。脾恶性肿瘤临床预后差。

Objective To summarize the experience in clinical diagnosis and treatment of splenic spontaneous rupture.Methods Clinical data were reviewed retrospectively for 16 patients with splenic spontaneous rupture at our hospital from Jan. 1995 to July 2002. Results Of the 16 patients, 2 were diagnosed as having splenic cyst, 4 having splenic angioma and 10 having splenic malignant tumors. Fourteen patients underwent emergency laparotomy and splenectomy. Two with fake rupture underwent splenectomy within a definite time. The postoperative prognosis of splenic malignant tumors was poor. All malignant patients were alive from 2 months to 4.5 years. One patient with splenic lymphoma of clinic Ⅰ stage was still alive for 4.5 years. Conclusion The preoperative diagnosis of splenic spontaneous rupture is difficult because of their complicated causes. Most of them are malignant. So the patients have to undergo laparotomy and splenectomy. Splenic malignant tumors have a poor prognosis.