延迟性脾破裂的临床探讨

目的：总结延迟性脾破裂的诊治经验。方法：回顾分析1993～2001年收治13例患，结合献讨论延迟性脾破裂的概念、诊断及外科治疗。结果：13例术前经病史、体检、诊断性腹腔穿刺、B超及CT检查而确诊；急诊行脾切除术5例、部分脾切除术和脾脏修补术各4例均治愈，无并发症。结论：延迟性脾破裂往往在受伤时即有脾损伤，而诊断却在48h之后，易致误诊。诊断时需仔细询问病史，严密动态观察病情及有效辅助检查，根据患的不同情况，选择不同的手术方式。

Clinical study of delayed rupture of spleen

Objective:To study the diagnosis and treatment of delayed rupture of spleen.Methods:Thirteen patients with delayed rupture of spleen from 1993 to 2001 were analyzed retrospectively and literatures were reviewed.Results:The patients were diagnosed by case investigation,physical examination,exploratory abdominocentesis,B-ultrasonography and CT.All patients were cured with emergency splenectomy in 5 cases,partial splenectomy in 4 cases,repair of spleen 4 cases.No complication occurred.Conclusion:Generally,delayed rupture of spleen occurred when wounds,but the diagnosis was delayed after 48 hours,misdiagnosis occurred easily.Therefore,it should be diagnosed by case investigation carefully,dynamic observation,strictly,and effectively accessory examinations should be used.The treatment of patients according to various symptoms,various surgery methods are used.