创伤性脾破裂91例诊治体会

目的总结创伤性脾破裂的诊治体会,提高脾破裂诊治水平。方法回顾分析2004年7月～2009年12月我院收治91例创伤性脾破裂的诊断和治疗。结果根据病史、体征、腹腔穿刺、B超、CT等确诊35例（38.5%）,以腹腔内出血剖腹探查确诊56例（61.5%）;非手术治疗5例（5.5%）,手术治疗86例（94.5%）,其中全脾切除84例,脾修补术2例;死亡2例,1例术中死亡,1例术后并发多器官功能衰竭死亡,余均治愈。结论早期诊断,及时正确处理是脾破裂救治关键,重视术中自体血回输及脾损伤以外复合伤处理提高救治成功率。

Diagnosis and treatment of traumatic splenic rupture:with a report of 91 cases

Objective To summarize our experiences in the diagnosis and treatment of traumatic splenic rupture（TSR）,in order to improve the diagnosis and treatment effect of TSR.Methods Retrospective analysis of the diagnosis and treatment of 91 patients with traumatic splenic rupture from July 2004 to December 2009 in our hospital was made.Results According to medical history,physical signs,abdominocentesis,type-B ultrasonic,CT 35 cases are confirmed（occupying 38.5% of the whole group）,and 56 cases are confirmed by intraperitoneal hemorrhage and abdominal laparotomy（occupying 61.5% of the whole group）.There are five non-operating therapy（5.5%）and 86 cases of operation therapy（94.5%）.Among the previous cases there are 84 cases of total iridectomy,2 cases of spleen prothesis;two cases of death,and of the two one died during the operation;the other dies of hepatic failure of multiple organ dysfunction after the operation,the rest of which being cured.Conclusion In early diagnosis,to treat properly is the key measure to spleen rupture.Stressing on the autoblood＇s feedback during the operation as well as treatment of spleen injury and other combined injury can improve the treating success ratio.