外伤性脾损伤的CT分级及临床意义

目的探讨CT扫描对脾损伤诊断与治疗临床价值。方法回顾分析我院2006～2011年收治57例经CT检查的外伤性脾损伤的临床资料。结果根据CT表现进行脾损伤分成四级:Ⅰ级7例(12.3%),主要表现为包膜下积血;Ⅱ级18例(31.6%),CT表现为脾外周撕裂;Ⅲ级21例(36.8%),CT表现为脾实质撕裂;Ⅳ级11例(19.3%),CT表现为粉碎性脾;其中Ⅰ级和部分Ⅱ级病例行保守治疗16例(28.1%),部分Ⅱ级及Ⅲ级以上行手术治疗41例(71.9%),均治愈出院。术前CT扫描诊断符合率96.3%。结论多排螺旋CT不仅为诊断脾损伤提供了直观的形态学依据,而且能较准确早期判断脾损伤的病情,并能大概估计腹腔积血量及较明确的提示合并伤;对其临床治疗方案的选择及预后的判断具有重要意义。

CT Grading and Clinical Significance of Traumatic Spleen Injury

Objective To investigate the CT scan splenic injury diagnosis and treatment of clinical value. Methods A retrospective analysis of our hospital from 2006 to 2011 admitted to the clinical data of 57 cases CT examination of traumatic splenic injuries. Results According to the CT findings of splenic injury is divided into four..7 cases of grade Ⅰ （12.3%）, mainly for the subcapsular hemorrhage, Ⅱ in 18 patients （31.6%）, CT performance for the spleen and peripheral tear, grade Ⅲ, 21 cases （36.8%）, CT performance of the splenic substance tearcrack, fourth level 11 cases （19.3%）, CT manifestations of comminuted spleen; Ⅰ and some cases of grade lI were treated conservatively, 16 cases （28.1%）, part of the class Ⅱ and Ⅲ level and above, underwent surgery in 41 cases （71.9%） were cured. Preoperative CT scan diagnosis rate of 96.3%. Conclusion Multi-slice spiral CT not only for the diagnosis of splenic injury in an intuitive basis of morphology, and can more accurately early to judge the condition of the spleen injury, and a rough estimate of the of hemoperitoneum blood and clear prompts associated injuries, its clinical treatmentprogram selection and prognostic significance.