超声动态监测在外伤性脾破裂非手术治疗中的应用

目的探讨超声动态监测在外伤性脾破裂非手术治疗中的应用价值。方法对25例外伤性脾破裂患者进行非手术治疗,超声动态监测重点观察脾脏回声和腹腔积液等情况,并严密监测临床体征。结果 25例患者中诊断为真性脾破裂14例,中央性脾破裂5例,包膜下脾破裂6例;首次超声检查确诊16例,经超声动态监测确诊9例。其中22例患者经非手术治疗成功,超声复查提示脾内血肿缩小或基本吸收,腹腔积液减少或消失;3例患者经超声动态监测后确认非手术治疗无效而中转急诊手术。结论超声动态监测脾内损伤情况及腹腔内积血的变化,能直观、实时地显示外伤性脾破裂非手术治疗中的病情进展情况;早期阶段实施床边超声检查有助于提高非手术治疗的成功率,而对可疑者进行超声动态监测则有助于尽早确诊。综合临床体征观察和超声动态监测可作为外伤性脾破裂非手术治疗的首选监测手段。

The application of dynamic ultrasound monitoring in nonoperative treatment for traumatic splenic rupture

Objective To study the application of dynamic ultrasound monitoring in nonoperative treatment for traumatic splenic rupture. Methods Treat 25 cases of traumatic splenic rupture with nonoperative treatment,dynamic ultrasound monitoring should pay intensive observations on echoes of spleen and ascites,monitor the clinical vital signs exactly. Results Fourteen cases are diagnosed true splenic rupture,5 eases are central splenic rupture,6 cases are subcapsular splenic rupture; sixteen cases are diagnosed exactly at first time,another 9 cases get correct diagnosis through dynamic ultrasound monitoring. Twenty-two cases heal traumatic splenic rupture with nonoperative treatment, uhrasonography show hematoma in spleen and ascites diminish or disappear;another 3 cases have to get operative treatment. Conclusion Dynamic ultrasound monitoring on spleen injuries and ascites could reveal real time progress of patient condition directly;bedside ultrasonography improve rate of success in nonoperative treatment,dynamic ultrasound monitoring is the value to identify suspicious cases. Combine clinical vital signs monitor and dynamic ultrasound monitoring could be first monitor means in nonoperative treatment for traumatic splenic rupture.