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目的 总结分析脾动脉瘤的诊断和治疗方法。方法 回顾性分析 2 6例临床资料 ,包括影像学资料、治疗方法及治疗效果。结果 CT或彩色超声等影像学检查显示脾动脉扩张成瘤 ,梭形或球形 ,7例脾动脉瘤切除脾动脉重建以及 15例脾动脉瘤和脾脏切除者均获得临床治愈。 1例术后 3年死于脑出血 ,1例术后 4年死于心肌梗塞 ,余病例随访 2～ 5年均健康生活、无复发。 4例介入治疗者 1例术后 6d出现脾脏部分梗塞、继发感染 ,静脉应用大量抗生素 7d后得到控制 ,治愈出院 ,余 3例动脉瘤消失 ,脾脏萎缩 ,随访 2年以上无复发。结论 CT、彩色超声对脾动脉瘤的诊断治疗具有较高的临床价值 ,动脉瘤切除是脾动脉瘤的首选治疗方案 ,其近远期疗效较好 ;介入治疗在严密观察和预防继发感染的条件下实施亦可取得良好的治疗效果。
Objective To summarize and analyze the diagnosis and treatment of splenic aneurysms. Methods A retrospective analysis of 26 cases of clinical data, including imaging data, treatment and treatment. Results CT or color ultrasound imaging showed splenic artery expansion, spindle or sphere, 7 cases of splenic aneurysm resection of the splenic artery reconstruction and 15 cases of splenic aneurysms and splenectomy were cured. One patient died of cerebral hemorrhage 3 years after operation, one died of myocardial infarction 4 years after operation, and the remaining cases were followed up for 2 to 5 years with healthy life without recurrence. One patient in 4 patients who received intervention showed partial infarction of the spleen 6 days after operation. After secondary infection, a large number of antibiotics were intravenously administered for 7 days. The patients were cured and discharged. The other 3 patients disappeared and the spleen atrophied. No recurrence occurred after more than 2 years of follow-up. Conclusions CT and color ultrasound have high clinical value in the diagnosis and treatment of splenic aneurysms. Aneurysm resection is the first choice for treatment of splenic aneurysms, and the curative effect in short-term and long-term is good. Interventional therapy is closely related to the prevention and treatment of secondary infection Under the conditions of implementation can also obtain good therapeutic effect.