目的总结创伤性脾破裂的诊治经验,进一步提高救治水平. 方法回顾性分析1992～2000年间连续收治的293例脾破裂患者的诊断与治疗. 结果根据外伤史、临床表现、诊断性腹腔穿刺、腹部B超和(或)CT等检查结果,诊断符合率为96.3%.本组非手术治疗31例,全部治愈;手术治疗259例,治愈250例,其中并发脾窝积液7例.全组共治愈281例,治愈率为95.9%;死亡12例,死于大出血和严重多发伤. 结论创伤性脾破裂行脾切除术疗效肯定,并发症发生率和死亡率低,对重度失血性休克和严重多发伤患者应采取更积极的外科治疗策略.
Objective To summarize the experience in the diagnosis and treatment of traumatic spleen rupture.MethodsThe diagnosis and treatment of consecutive 293 patients with traumatic spleen rupture from January 1992 to October 2000 were reviewed.ResultsThe diagnosis was established by the history of injury, clinical presentations, diagnostic peritoneal punctures, abdominal ultrasonography and/or CT. The accuracy rate of diagnosis was 96 3% (282/293). Thirty one patients were treated nonoperatively and cured. Two hundred and fifty of 259 patients treated operatively were cured.Seven had postoperative complications with effusion in the splenic fossa.The total cure rate was 95 9%(281/293).Twelve patients died of uncontrolable hemorrhage or severe multiple injuries.ConclusionsSplenectomy for the treatment of traumatic spleen rupture is satisfactory.The morbidity and mortality of splenectomy are low.
Chinese Journal of General Surgery