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| 題 名 | Delayed Splenic Rupture=延遲性脾臟破裂 |
|---|---|
| 作 者 | 陳瑞杰; 卜樂得; 方禎鋒; 林炳川; 陳炯林; 徐榆堡; 陳敏夫; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 29:6 民85.11-12 |
| 頁 次 | 頁474-478 |
| 分類號 | 415.649 |
| 關鍵詞 | 延遲性脾臟破裂; Delayed splenic rupture; Acute abdomen; |
| 語 文 | 英文(English) |
| 中文摘要 | 為評估延遲性脾臟破裂之特性及其預後,並思由正確之診療計劃來避免 延遲診斷。由民國七十七年至八十一年,五年期間長庚紀念醫院林口醫學中心, 共有10例合乎延遲性脾臟破裂之診斷,平均延遲時間為11.2天。8例近期曾有外傷 事故,另外兩例則有酒醉及顱病發作。術前診斷,5例藉由腹部超音波,3例藉由 腹部電腦斷層攝影,I例由診斷性腹膜灌洗術,另I例由理學檢查。手術前的診斷 時間平均達9.3小時。10例全部接受剖腹手術,並採脾臟切除。術中腹內之積血 量平均達1870毫升,且其手術中失血量平均達110毫升。 引發左上腹部之疾病並不多。因此對於突發性左上腹痛之病患,應該加以詢問前 一個月中有無輕微的外傷,以及酒醉或癲癇發作,來懷疑為延遲性脾臟破裂。同 時也可藉助腹部超音波或電腦斷層來證明,以便早期診斷延遲性脾臟破裂,立即 進行手術止血來減少不必要輸血。 |
| 英文摘要 | To evaluate the features and outcomes of delayed splenic rupture in thehope of developing a strategy to avoid future delayed diagnoses, all splenicinjury patients treated over a 5-year period (1988-1992) in Chang GungMemorial Hospital were reviewed, and 10 patients were found to meet thecriteria for delayed splenic rupture. The average period of delay was 11.2days. Eight had histories of trivial trauma, while the other two had historiesof alcohol abuse and seizures. The diagnosis was made by abdominal ultrasound in five, abdominal computed tomography in three, by diagnostic peritoneal lavage in one and on clinical grounds alone in the other. The average period of preoperative evaluation was 9.3 hours (4-17 hours). All underwent surgery and all required splenectomy. The average intraperitonealblood volume at the time of laparotomy was 1870 ml. The average intraoperative blood loss was 110 ml. Differential diagnosis of left upper quadrantabdominal pain is limited. A history of trivial or questionable trauma, suchas inebriation or seizure within the previous month, should always be elicited, followed by abdominal sonography or computed tomography wheneverin doubt. The early diagnosis of delayed splenic rupture, allows for earlysurgery to reduce the amount of blood transfusion required. |
本系統中英文摘要資訊取自各篇刊載內容。