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随着城市人口增加和孕妇活动频繁,孕期意外损伤发病率已有增高,国外报道虑外损伤的发病率可达所有妊娠的6～7%。孕期脾破裂(包括脾动脉瘤破裂)为孕妇意外损伤较为罕见的一种合并症。国内尚无孕期脾破裂报道。冯惠娟报道妊娠合并脾蒂周围血管破裂2例。50年代前孕期脾破裂母婴死亡率分别为26%和63%。为重视孕期这一合并症,谈几点看法,供同道参考。一、发病机理孕期脾破裂可分为两大类:创伤性破裂与自发性破裂,以后者为多见。瞬时破裂常伴有腹部钝器伤,延缓破裂者常为瞬时破裂的延续。脾严重创伤时,血液流入脾实质,此期被膜仍保持完整,约48小时或更长时间,被膜下压力增高,包膜破裂。几乎3/4病例脾实质出血初期无症状,因损伤后先成囊内破裂,后被膜再破裂,发生腹腔内出血才出现症状。
With the increase of urban population and the frequent activities of pregnant women, the incidence of unintended injuries during pregnancy has increased. The incidence of extra-reported injuries in foreign countries can reach 6 to 7% of all pregnancies. Splenic rupture during pregnancy (including splenic aneurysm rupture) is a rare complication of accidental injury in pregnant women. Domestic spleen rupture reported during pregnancy. Feng Huijuan report of pregnancy with splenic peripheral vascular rupture in 2 cases. The pre-pregnancy spleen rupture in the 50s was 26% and 63%, respectively. To attach importance to this complication of pregnancy, talk about the views for fellow reference. First, the pathogenesis of spleen rupture during pregnancy can be divided into two categories: traumatic rupture and spontaneous rupture, the latter is more common. Instantaneous rupture often accompanied by abdominal blunt injury, delaying rupture are often the continuation of instantaneous rupture. Spleen severe trauma, the blood flows into the spleen parenchyma, the period of the film remains intact, about 48 hours or longer, under the capsule pressure increases, the capsule rupture. Almost 3/4 cases of early spleen pustular hemorrhage asymptomatic, due to injury after the first capsule rupture, and then rupture of the capsule, the occurrence of intra-abdominal bleeding before symptoms.