超声造影在脾外伤保脾手术中的应用价值

目的：探讨超声造影在脾外伤保脾手术中的应用价值。方法：46例脾外伤患者行保脾手术治疗，应用常规超声与超声造影对其术前及术后进行监测。结果：46例脾外伤手术分级，Ⅱ级5例，Ⅲ级32例，Ⅳ级9例；常规超声共检出42例，漏诊4例；超声造影对46例损伤均作出诊断，其中9例可见造影剂外溢。术后常规超声发现1例腹腔积液进行性增加；超声造影发现2例并发症，1例脾动脉主干受压，1例患者术后发生感染难以控制，其脾脏术后增强体积小于原来体积的1/5。结论：超声造影能够为脾外伤保脾手术术前提供选择依据，术后进行监测和随访，对于发现并发症、伤情变化以及预后有重要作用。

Application of contrast-enhanced ultrasound in spleen-preserving operation for splenic trauma

Objective： To investigate the application of contrast-enhanced ultrasound（CEUS） in operation of splenic trauma.Methods： Forty-six patients with splenic trauma underwent spleen-preserving operations.Both ultrasonography and CEUS were applied for preoperative and postoperative monitoring.Results： Forty-six patients with splenic trauma were classified as follows： 5 patients in Grade Ⅱ,32 in Grade Ⅲ and 9 in Grade Ⅳ.Conventional ultrasound successfully detected trauma in 42 patients but failed in 4 patients;CEUS diagnosed 46 patients correctly,among which contrast agent overflow was seen in 9 cases.Postoperatively,one patient was found with progressive increase of seroperitoneum,yet two patients with complications were detected by CEUS： one patient＇s splenic artery trunk was pressed,while the other suffered uncontrollable postoperative infection whose volume was less than 1/5 of the original volume after spleen surgery.Conclusions： CEUS offers preoperative basis for the spleen-preserving operation for splenic trauma and is also applied for monitoring and following-up after operation.Thus it has great significance in discovering complications,traumatic state and prognosis.