腹部脏器损伤CT诊断.docVIP

腹部脏器损伤CT诊断 　【关键词】 腹部 摘要：目的：介绍腹部脏器损伤中的CT诊断作用及其表现。方法：54例腹部脏器损伤中，43例为单一脏器损伤，11例为多脏器损伤。受伤脏器分别为脾23例、肝16例、肾13例、胰腺2例、膀胱3例、肠和肠系膜4例。全部病例均在受伤后8小时内进行CT平扫检查，部分病历做增强扫描。结果：CT容易发现腹内脏器损伤的部位、不同类型破裂和不同程度出血。对并发的腹壁、腹腔及后腹膜腔、脊柱、肋骨等损伤也能同时检出。增强CT检查对损伤的诊断明显优于平扫。结论：CT对腹部脏器损伤具有很高的敏感性和特异性，为外科医师决定治疗方案提供重要的依据。 关键词：CT；损伤；腹部脏器损伤 CT Diagnosis of Abdominal Visceral Injury Abstract: Objective: Introducting the value of CT technique and finding in diagnosing abdominal parenchymal visceral injury.Method:54 cases abdomen by visceral trauma including 43 cases of single and 11 multiple visceral involvement respectively.The distributions were as following,spleen 23 cases, liver 16 cases, kidney 13, pancreas 2, bladder 3, intestines andmesentery 4.All cases were undergone conventional CT scanning within 8 hours after injury. Do the scanning of strengthening in some case histories. Result:It’s easy for CT scan to discover the different types of rupture and variable degrees of hemorrahages of abdominal visceral parenchymal injury,and also the complicaltions occurred on abdominal wall,abdomial and retroperitoneal cavities,spine,rib etc,simultaneously. Strengthens the CT inspection obviously to surpass to the damage diagnosis evenly sweeps. Conclusion: It has very high sensitivenesses and peculiar that CT scans and damages the belly internal organs ,Offer the important basis for the thing that the surgeon decides the healing solution. Key words：CT；Injury；Abdominal visceral injury 1材料和方法 1.1一般资料：本文选取本院近2年CT检查发现的54例腹部脏器外伤所致的内脏损伤进行分析，致伤原因首推外伤车祸，占80%，男33例，女21例，年龄为10～62岁，平均31岁，54例中43例为单一脏器损伤，11例为多脏器损伤，单一受伤脏器分别为脾16例、肝9例、肾9例、膀胱损伤3例、肠和肠系膜4例。 1.2方法：CT扫描采用GEprospeed系列螺旋CT机，层厚10cm，间距10cm。扫描范围根据受伤情况而定，所有患者均作平扫检查，其中12例扫描前30～45min，口或经鼻饲管给予2%～3%泛影葡胺500ml，使胃腔内充满高密度的对比剂，上床是250ml，其余病例直接平扫，12例又加作了CT增强扫描，21例经手术证实，其余经CT短期随访及临床检验、B超、腹腔穿刺等综合方法证实。 2结果 2.1肝损伤16例，单发肝损伤9例，多发7例。肝钝性伤1级10例，肝包膜撕裂，表面撕裂小于2cm深，包膜下血肿直径小于1cm；2级4例，肝撕裂13cm深，中央和包膜下血肿直径为1～3cm；3级2例，肝撕裂深度大于3cm，实质内和包膜下血肿直径大于3cm。 2.2脾损伤23例，单发损伤16例,多发7例。1级14例，表现为局限性包膜撕裂及小的包膜下血肿