脾动脉瘤7例诊治分析
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    Diagnosis and treatment of 7 cases of splenic aneurysm
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      摘要:

      目的:探讨脾动脉瘤的诊断和手术治疗方法。
      方法:回顾性分析7 例脾动脉瘤患者的临床资料。
      结果:6例经彩色多普勒超声(B超)初步诊断;4例经CT动脉造影(CTA),2例经数字减影血管造影术(DSA),1例经磁共振造影(MRA)确诊;无1例依靠临床症状而确诊。单纯脾动脉瘤切除术1例,脾动脉瘤加脾脏切除术1例,脾动脉瘤切除加动脉重建术1例,动脉瘤近远端脾动脉结扎术1例,脾动脉瘤栓塞术2例,脾动脉瘤栓塞术加脾切除术1例。随访2个月至3年。无死亡及严重并发症病例。
      结论:脾动脉瘤依赖临床表现难以诊断,B超有筛选价值,CTA,MRA,DSA均有诊断价值。一旦确诊应尽早选择腔内介入栓塞治疗或手术方法。

      Abstract:

      Objective:To investigate the methods of diagnosis and treatment of splenic aneurysms(SA).
      Methods :Clinical data of 7 SA cases was retrospectively analyzed.
      Results:Preoperatively, preliminary diagnosis was made based on type-B ultrasonic scanning in 6 cases, diagnosis was confirmed by CT angiogrophy(CTA) in 4 cases, by digital substraction angiography(DSA) in 2 patients and magnetic resonance angiography(MRA) in 1 case, but no case was confirmed solely by clinical symptoms. Of the 7 cases, 1 underwent splenic aneurysm resection, 1 combined resection of splenic aneurysm and spleen, 1 had resection of splenic aneurysm and reconstruction of splenic artery, 1 ligation of proximal and distal splenic arteries, 2 endovascular embolization, and 1 endovascular embolization and resection of spleen. All patients were followed up for 2 months to 3 years, but no mortality or serious complications were found.
      Conclusions:It is difficult to diagnose splenic aneurysm based solely on clinical symptoms, but CTA, MRA and DSA are importtant for diagnosis. B-mode ultrasond is of help for screening. Endovascular embolization or surgical procedure should be employed once the diagnosis is confirmed.

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    胡国富, 金毕, 欧阳晨曦,李毅清.脾动脉瘤7例诊治分析[J].中国普通外科杂志,2009,18(7):24-.
    DOI:10.7659/j. issn.1005-6947.2009.07.024

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    • 在线发布日期: 2009-07-25