不同病因腹膜后血肿的临床特点及影像诊断VIP免费

植床和实验医学毒志2010年6月第9卷第11期·829·不同病因腹膜后血肿的临床特点及影像诊断吴伟清肖珍科张亿星(广州市中医医院放射科广东广州510130)【摘要】目的探讨不同病因腹膜后血肿的临床特点与诊断。方法回顾性分析63例腹膜后肿，外伤性血肿组41例，术后腹膜后血肿组16例，非外伤性腹膜后血肿组6例。诊断主要是B超、腹穿和CT；比较各组血肿的发生部位、大小、动态变化、血压、临床主诉、误诊等。分析不同血肿的诊断、误诊率及原因。结果l8例外伤性腹膜后血肿有动态和血压的变化，其余23例则稳定。各组血肿部位、大小和临床症状相差不大。外伤组与术后组和非外伤组误诊率分别8％、32％、33％，前者与后两组相差显著(P<0．05)。结论创伤组较其它组更易出现血肿动态增大和血压波动。后腹膜血肿要影像学动态观察，误诊原因主要是过分强调B超和腹穿而忽视了CT的作用。【关键词】腹膜后血肿病因临床特点诊断Retroperitonealhaematomaindiferentetiologies：clinicalcharacteristicsanddiagnosis．WUWei—qing，XIAOZhen一妇，ZHANGH—xing．DepartmentofRadiology，TheChineseMedicalHospitalofGuangzhouCity，GuangzhouGuangdong510130，China．【Abstract】objectiveToinvestigatethediagnosisandclinicalfeaturesonretropefitonealhematomacausedbydiferentetiologies．Meth-otisClinicaldataof63casesofretroperitonealhematomawerestudiedretrospectively．41of63caseswerecausedbytrauma；16of63werebypost—abdomenoperationand6caseswithnon—traumaandnon—traumahistory．Themaintoolstodiagnosisthesepatientswereultrasound．ab—dominalpunctureandCTscan；Thesize，location，changes，bloodpressure，complainsandtherateofmisdiagnosisofEachlesionsindiferentgroupspatientwerebeencompared．Results18of41traumatichematomahaddynamicchangesbethinvolumeandpressure．23of43withoutanychanges．Thesymptoms，signs，location，sizeindiferentgroupshadnosignificance．Therateofmisdiagnosiswere8％(traumaticgroup)，32％(post—operationgroup)and33％(non—traumaticgroup)．ThereWassignificantdiferencebetweentherateoftraumaticgroupsandthatofothertwogroups(P0．05)。见表3。表3不同血肿组的影像学表...