Management of blunt splenic trauma: computed tomographic contrast blush predicts failure of nonoperative management.
Management of blunt splenic trauma: computed tomographic contrast blush predicts failure of nonoperative management.
复制标题
钝性脾损伤的处理：计算机断层扫描对比红晕可预测非手术处理的失败。
DOI：
10.1097/00005373-199509000-00018
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
F. E. Pritchard
中科院分区：
文献类型：
--
作者：
M. Schurr;T. Fabian;M. Gavant;M. Croce;K. Kudsk;G. Minard;G. Woodman;F. E. Pritchard
钝性脾损伤的非手术治疗已被广泛接受；然而，据报道故障率高达 40%。能够可靠地识别故障的因素很少。为了更好地描述非手术治疗失败的情况，我们回顾性回顾了 5 年来在我们的一级创伤中心治疗的 309 例钝性脾损伤。 89 名患者最初接受非手术治疗（29%），12 名患者失败（13%）。在审查最初的计算机断层扫描后，在 12 名失败患者中的 8 名 (67%) 和 77 名成功非手术治疗患者中的 5 名 (6%) 中注意到脾实质中造影剂的高密度聚集，或“对比色红”(p < 0.0001)。这些数据表明，在决定脾损伤的处理方法时，对比红的存在是一个重要的考虑因素。如果这些结果以前瞻性方式得到证实，则可以通过识别对比红来降低钝性脾损伤的非手术治疗的失败率。
Nonoperative management of blunt splenic trauma is widely accepted; however, reported failure rates have ranged as high as 40%. There are few factors available to identify failures reliably. To characterize failures of nonoperative management better, we retrospectively reviewed 309 blunt splenic injuries treated at our level I trauma center over a 5-year period. Eighty-nine patients were initially managed nonoperatively (29%), and 12 patients failed this approach (13%). Upon review of the initial computed tomography scans, a hyperdense collection of contrast media in the splenic parenchyma, or "contrast blush," was noted in 8 of 12 (67%) patients who failed and in 5 of 77 (6%) of those who were successfully managed nonoperatively (p < 0.0001). These data suggest that the presence of a contrast blush is an important consideration when deciding the method for management of the splenic injury. If these results are confirmed in a prospective fashion, the failure rate of nonoperative management of blunt splenic trauma could be reduced by identification of the contrast blush.