腹部卒中9例临床的的特点及诊治分析.docVIP

腹部卒中9例临床的的特点及诊治分析 　　摘要：目的 探讨腹部卒中的临床特点和诊断、治疗，引起临床医生的重视。方法 回顾性分析9例腹部卒中患者的病因、起病特点、诊断及治疗。结果 9例腹部卒中患者男女比例为1/2（3/6），病因多样，起病急，多数以腹痛及失血性贫血为主要表现，术前均未明确诊断急诊剖腹探查，7例找到出血病灶并成功止血，2例未找到出血病灶，其中1例因术后二次出血死亡，其余均痊愈出院。结论 腹部卒中临床少见，术前确诊率低，彩超、CT及腹腔穿刺为最有效的检查方法，积极抗休克治疗及剖腹探查为目前首选治疗方案。 　　关键词：腹部卒中；诊断；治疗 　　Abstract：Objective This article aims to probe into the clinical manifestation as well as the corresponding diagnosis and treatment for patients with abdominal apoplexy in order to draw clinicians attention. Methods Nine cases regarding patients with abdominal apoplexy were retrospectively analyzed in this article in terms of the pathogenesis ， onset characteristic， diagnosis and treatment. Results The sex ratio between the male patients and the female patients suffering from abdominal apoplexy in our hospital is 1：2 ， including three men patients and six women patients. The pathogenesis of the nine cases is various and the onset characteristic is emergent； meanwhile， abdominal pain and blood loss anemia are the major symptoms for most of the nine patients. Besides， all of them had not adopted the emergency abdominal laparotomy to define the corresponding diagnostic scheme before the operations. The bleeding focuses of seven patients were diagnosed and their blood was stopped successfully， while the bleeding focuses of two patients were not found， one of whom died from the second bleeding after the operation. Finally， all of the other eight patients were cured and left hospital. Conclusion The abdominal apoplexy is a rare clinical symptom with a low diagnosis-rate before operation. Currently， Color Doppler Ultrasound， CT and abdominocentesis are the most effective check-up methods； accordingly， the positive anti-shock therapy and the abdominal laparotomy are the primary medical treatment schemes. 　　Key words：Abdominal apoplexy；Diagnosis；Treatment 　　腹部卒中是指腹腔内或腹膜后血管自发性破裂，导致腹腔内出血，常以骤然发作的腹痛和低血容量休克为主要表现的急腹症[1，2]。本病不含腹部外伤、自发性实质器官或宫外孕破裂出血，病因不明确，术前诊断困难，易延误诊治，预后差，本文现将2000年～2015年5月我院9例腹部卒中报告如下。