摘要
目的总结自发性脾破裂的诊治经验。方法对1987年7月～2004年12月收治的18例自发性脾破裂患者的临床资料进行回顾性分析。结果全组18例中,充血性脾肿大4例(3例肝炎后肝硬化,1例血吸虫性肝硬化),原发性脾恶性淋巴瘤2例,结肠癌及胰尾癌浸润脾脏各1例,慢性粒细胞性白血病1例,脾海绵状血管瘤1例,脾脏囊肿2例,不明原因脾肿大4例,正常脾脏2例。急诊脾切除术14例,其中联合胰尾癌切除1例,联合结肠癌切除、结肠造瘘术1例。非手术治疗4例,其中1例因发热持续不退,1例因脾周血肿增大、疼痛加重而中转脾切除术;脾包膜下出血2例经非手术治愈。本组治愈16例,死亡2例。结论病理性脾脏是自发性脾破裂的主要原因。脾切除术是治疗自发性脾破裂的主要手段。
Objective To summarize the experience in clinical diagnosis and treatment of spontaneous splenic rupture.Methods The clinical data were reviewed retrospectively for 18 patients with spontaneous splenic rupture in our hospital from July 1987 to Dec.2004.Results Of the 18 patients,there were 4 cases of congestive splenomegaly(post-hepatitis and schistosome cirrhosis),2 cases of primary spleen malignant lymphoma,one case of colon carcinoma and pancreatic tail carcinoma invading directly to spleen respectively,one case of chronic granular cell leukaemia,one case of splenic angioma,2 cases of splenic cyst,4 cases of splenomegaly with uncertained causes,2 cases of normal spleen.Fourteen cases were subjected to emergence splenectomy.Among them,1 case received combined resection of colon carcinoma and colostomy,and one case combined resection of pancreatic tail carcinoma.Four cases received non-operative treatment.Among them,2 cases were converted to splenectomy.Two cases of subcapsular hematoma were cured by non-operative treatment.Sixteen cases were cured and 2 cases died.Conclusion Pathologic spleen was the main cause of spontaneous splenic rupture and splenectomy was the main operative style for spontaneous splenic rupture.
出处
《临床外科杂志》
2005年第7期423-425,共3页
Journal of Clinical Surgery
关键词
脾破裂
自发性
诊断
治疗
splenic rupture,spontaneous
diagnosis
treatment
