外伤性脾破裂112例诊治体会.docVIP

外伤性脾破裂112例诊治体会 【摘要】 目的 探讨外伤性脾破裂的诊断和 治疗 。 方法 对112例外伤性脾破裂的诊断与治疗进行 分析 。结果 外伤性脾破裂112例，男77例，女35例，手术治疗102例，保守治疗10例。112例患者痊愈出院，无死亡病例。结论 详细询问病史，仔细体检，多部位反复腹穿，必要的辅助检查是减少脾破裂漏诊或误诊的主要因素。在急诊处理中，立即建立有效的静脉通道，及时抗休克治疗，保持呼吸道通畅并充分给氧是降低早期死亡的重要措施。外伤性脾破裂的治疗主张“保命第一，保脾第二”的原则，不轻易切脾，特别是小儿，但也不能盲目保脾。 【关键词】 脾破裂；脾切除术 Experience in diagnosis and treatment of traumatic rupture of spleen in 112 cases ［Abstract］ Objective To investigate the diagnosis and treatment of rupture of spleen.Methods Diagnosis and treatment of 112 cases with traumatic rupture of spleen were analysed retrospectively in this paper.Results 112 cases rupture of spleen，77 were males and 35 were females，102 patients were treated conservatively and 10 cases underwent operation.112 patients completely recoverd，there was no patients passed away.Conclusion It points out that detailed medical history-taking,careful physical examination,repeated abdominal paracentesis at multiple sites,and necessary accessory examinations are the major factors for avoiding missed diagnosis or misdiagnosis.During emergent treatment immediate establishment of effective venous passageway, timely carrying out antishock therapy,maintaining respiratory tract unobstructed, and supply of sufficient oxygen are improtant measures to be taken to reduce death in the early stage. The author holds that in treatment of traumatic rupture of spleen the principle of “life-saving first,spleen-preserving second” should be observed. The spleen should not be resected rashly,especially in children, while it should not be reserved without indications.The conditions of non-operative treatment, indications of splenectomy, and restrictive factors for restorative operation and partial resection of the spleen are also expounded in this paper. ［Key words］ splenic rupture；splenectomy 脾脏是一个血供丰富而质脆的实质性脏器，外伤、暴力很容易使其破裂而致大出血，危及生命。随着 社会 建设事业的 发展 及社会活动的增多，外伤性脾破裂的发生率逐年增加。我院1993年7月～2007年8月共收治外伤性脾破裂112例，其中病历记录完整者110例，现 总结 分析如下。 1 临床资料 11 一般资料 本组外伤性脾破裂112例，男77例，女35例。年龄最小6岁，最大74岁，平均32