To explore the spiral CT in closed spleen damage diagnosis and treatment of clinical value guidance. Methods 2003 years April to May 2011, of the 80 cases of patients with closed spleen injured, we use ultrasonic and clinical data were analyzed retrospectively, compared with the diagnostic accordance rate of ultrasonic CT. Results The spleen damage CT: level I level included subcapsular hematoma (29 cases), Ⅱ level (spleen peripheral tear) in 23 cases, Ⅲ level (spleen essence tear) in 19cases, IV level (spleen rupture) comminuted 9 cases, of which level I and some Ⅱ 44 cases level underwent conservative treatment successfully, and the rest of 36 patients underwent surgical treatment. Preoperative diagnosis was 95.0% , CT is significantly higher than the ultrasound 82.5% P <0.05; CT prior to the other united injury rate is higher than that of ultrasound. Conclusion CT examination in blunt is not only high damage preoperative diagnosis with spleen, but also has certain directive significance, which is the first choice for the damage of closed spleen.%目的 探讨螺旋CT在闭合性脾脏损伤诊断及指导治疗方面的临床价值.方法 对2003年4月～2011年5月我院收治的80例闭合性脾脏损伤患者的CT、超声及临床资料进行回顾性分析,比较CT与超声的诊断符合率.结果 脾损伤CT级:Ⅰ级(包膜下血肿)29例、Ⅱ级(脾外周撕裂)23例、Ⅲ级(脾实质撕裂)19例、Ⅳ级(粉碎性脾破裂)9例,其中Ⅰ级及部分Ⅱ级患者行保守治疗成功36例,其余44例行手术治疗.术前CT诊断符合率95.0％,显著高于超声的82.5％,P ＜0.05；CT术前对其他合并伤的发现率高于超声.结论 CT检查不仅对闭合性脾损伤术前诊断符合率高,而且对临床合理选择治疗方案具有一定的指导意义,是闭合性脾脏损伤的首选检查方法之一.
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