脾梗死的基础解剖与临床研究  

Anatomical and clinical research on splenic infarction

作　　者：夏绍友[1] 李荣[2] 李晨[2] 侯文宇[2] 王春喜[2] 宁宁[2] 

机构地区：[1]100853北京,解放军总医院,解放军总医院海南分院普通外科 [2]解放军总医院普通外科

出　　处：《中华肝胆外科杂志》2013年第10期738-741,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探索脾梗死的解剖学基础与临床成因，提高脾梗死诊治水平。方法分析2003年12月至2012年9月本院收治的11例脾梗死及1999年以来文献报道的131例脾梗死患者临床诊治资料，结合25具成人尸体脾动脉弯曲情况，分析脾梗死的成因。结果临床资料显示60岁以上老年人较高（73％比27％，P〈0．05），男性发病率高于女性（62％比38％，P〈0．05），内科首诊患者明显多于外科88／32（79％比21％，P〈0．05）。解剖资料显示，25具成人尸体中脾动脉多数呈弯曲状。结论脾梗死临床表现多样，易漏诊、误诊。提高脾梗死的诊疗水平有赖于增强诊断意识，加强血栓前状态检测和及时、规范的治疗。Objective To study the anatomical basis and clinical causes of splenic infarction with an attempt to improve on the diagnosis and treatment of splenic infarction. Methods This study was conducted on 11 patients with splenic infarction seen in our hospital from December 2003 to September 2012, 131 patients with a clinical diagnosis and treatment reported in the literature since 1999, and 25 adult cadavers showing the anatomy of the splenic arteries with an aim to find out the causes of splenic infarction. Results The clinical data showed that splenic infarction occurred more commonly in patients 60 years of age or older （73% vs 27%, P〈0.05）, and in males more than in females （62% vs 38%, P〈0.05）. The diagnosis was first made significantly more often by physicians than by surgeons 88/32 （79% vs 21%, P〈0. 05）. The anatomical data showed that the majority of the splenic arteries in the 25 adult cadavers was curved. Conclusions The clinical manifestations of splenic infarc- tion easily led to a misdiagnosis. Improvement in the diagnosis and treatment of splenic infarction would depend on the clinical awareness of this condition, the prothrombotic state detection and the im- plementation of timely and standardized treatment.

关 键 词：脾梗塞 脾动脉 诊断 

分 类 号：R657.6[医药卫生—外科学]