MSCT在开放式脾切除术后并发症评估中的应用价值
The Value of MSCT on Postoperative Complications Following Splenectomy
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摘要: 目的:总结开放式脾切除术后各种并发症的多层螺旋CT(MSCT)表现,探讨MSCT在脾切除术后并发症的评估中的应用价值。方法:回顾性分析行开放式全脾切除术后151例的患者的腹部CT表现,所有的患者均行64层螺旋CT平扫及双期增强扫描。结果:151例开放性脾切除术后出现并发症共60例,发生率为39.7%,包括近期并发症51例及远期并发症9例;近期并发症包括切口感染3例、其中1例发展成切口疝,膈下脓肿8例,胸腔积液和肺不张21例,静脉血栓14例(累及门静脉主干12例,门静脉分支2例、脾静脉8例、肠系膜上静脉4例、肾静脉1例、下腔静脉及髂总静脉1例),邻近脏器损伤5例(包括胰尾部损伤2例、降结肠、小肠损伤各1例、脾动脉损伤后动脉瘤1例);远期并发症包括门脉海绵样变1例和种植脾8例。结论:MSCT检查是评估脾切除患者术后情况和发现并发症的首选方法。Abstract: Objective: To investigate the value of multislice computed tomography(MSCT) diagnosing the complications following splenectomy.Methods: Retrospectively analyzed the abdominal MSCT appearances of 151 patients who had undergone full splenectomy in our hospital during January 2009 to December 2012.Results: Postoperative complications occurred in 60 patients(39.7%),including short-term complications(51 patients) and long-term complications(9 patients).Short-term complications: Wound infection(2 patients),incisional hernia(1 patients),subphrenic abscess(8 patients),pleural effusion and atelectasis(21 patients),thrombosis of vein(14 patients),Long-term complications: cavernous transformation of the portal(1 patients) and ectopic splenic autotransplantation(8 patients).Conclusion: MSCT is the optimal method on discovering the various imaging findings of postoperative complications following splenectomy.