目的 探讨术前腹腔B超检查联合血流动力学参数对外伤性脾破裂患者腹腔出血量的评估价值及临床意义.方法 回顾性分析2000年3月～2009年4月浙江省杭州市第一人民医院及浙江省临安市第一人民医院收治外伤性脾破裂行脾切除手术病例102例.统计术前腹腔B超所见脾周及盆腹腔积液范围联合血流动力学参数检查指标,结合手术中腹腔内实际出血量,分析其对外伤性脾破裂患者术前评估腹腔内出血量的价值.结果 术前腹腔B超检查发现盆腹腔内积液范围与腹腔内实际出血量有明显正相关性,血红蛋白( hemoglobin,HGB)以及血细胞比容(hematocrit,HCT)在脾周、肝肾隐窝、盆腔以及肠间隙3处以上出现积液时下降更加明显.结论 术前腹腔B超检查所见盆腹腔内积液范围能预测腹腔内的出血量,联合对血红蛋白以及血细胞比容的动态观测能更准确地预测腹腔内大量出血,对手术决策和手术时机的判断具有重要价值.%Objective To evaluate the bleeding of traumatical spleen with type - B ultrasonic and hemodynamic parameter. Meth-ods The clinical data about the bleeding of traumatical spleen were retrospectively collected (102 cases) from March 2000 to April 2009 in First People's Hospital of Hangzhou and First People's Hospital of Linan. The patients underwent splenectomy were observed and the factual bleeding amount were recorded before spleenectomy, which compared with the results of bleeding of abdominal cavity evaluated by preoperative abdominal type - B ultrasonic and some hemodynamic parameter. Results It was demonstrated that the range of hemoperito-neum in preoperative abdominal type - B ultrasonic combined with some hemodynamic parameter kept on with the factual amount of hemo-peritoneum significantly. Conclusion We found that preoperative abdominal type - B ultrasonic could predict the amount of hemoperito-neum in splenic rupture patients. Combining with hemoglobin and hematocrit detection would do better which will help surgical doctor to choose the best way for the patients with traumatical spleen.
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