彩色多普勒超声在外伤性脾破裂诊断及治疗中的应用价值

目的探讨彩色多普勒超声在外伤性脾破裂诊断及治疗中的应用价值。方法分析30例单纯性外伤性脾破裂患者的超声图像特点，包括直接征象与间接征象，与手术或CT比较，计算诊断准确率。对保守治疗的患者定期进行随访，彩色多普勒超声密切观察脾脏损伤区的缺血范围变化和腹腔积液变化。结果30例单纯性脾破裂中真性破裂20例、中央性破裂7例、包膜下破裂3例，与手术或CT比较，定位准确率达90％（27／30）。超声诊断脾破裂主要依据直接征象脾脏大小、脾包膜连续性、脾包膜下和脾内异常回声以及间接征象腹腔积液。结论超声因其实时、无创、移动方便、检查时间短、可重复等优点，有助于临床及时明确诊断并判断脾破裂的类型和程度，对临床治疗方案的选择和保守治疗的动态随访观察均具有重要价值。

The diagnosis and treatment value of color Doppler ultrasonography in traumatic splenic rupture

Objective To probe the diagnosis and treatment value of color Doppler ultrasonography in the traumatic splenic rupture. Methods The ultrasound characteristics of direct and indirect signs were analyzed retrospectively in 30 patients with traumatic splenic rupture. The surgery or CT and calculated the diagnostic accuracy were observed. The spleen injury changes and ascites change were observed. Results There were thirty cases with simple splenic rupture pa- tients, 20 cases with true rupture, 7 cases with central burst and 3 cases with subcapsular rupture. The positioning accu- racy was 90%. Ultrasound diagnosis of splenic rupture mainly based on the direct signs including spleen size, envelope continuity, abnormal echo under the spleen envelope and indirect signs of ascites. Conclusion Ultrasound because of its real-time, non-invasive, splenic rupture and play easy to move, shorter examination time and repeatable, may improve the diagnosis of traumatic an important role in treatment and follow-up.