本文選題：腹部CT平掃　切入點(diǎn)：急性腹直肌鞘血腫　出處：《中國農(nóng)村衛(wèi)生》2017年02期

【摘要】：目的:探討腹部CT平掃對(duì)急性腹直肌鞘血腫(RSH)的診斷價(jià)值。方法:選擇我院2014年4月到2015年4月經(jīng)臨床證實(shí)的20例急性腹直肌鞘血腫患者的CT平掃圖像及臨床資料進(jìn)行回顧性分析,并進(jìn)行統(tǒng)計(jì)學(xué)分析。其中20例患者中接受抗凝治療的有12例,抗血小板治療的5例。結(jié)果:經(jīng)過分析后,20例腹部CT平掃均正確診斷,共發(fā)現(xiàn)23處RSH(其中3例為雙側(cè)發(fā)病),其中位于上腹部10處、下腹部13處。RSH的CT平掃表現(xiàn)為圓形、橢圓形或不規(guī)則形高密度影,位于腹直肌的背部,部分可跨越腱劃,其形態(tài)與其發(fā)生的位置有關(guān),弓狀線以上的血腫由于受到腹直肌鞘的限制,血腫體積多較小,腹直肌呈梭形增粗,弓狀線以下腹直肌鞘后層由薄弱的腹橫筋膜及腹膜替代,血腫易向壓力較小的盆腔側(cè)突出,血腫多較大。20例中Ⅰ型血腫11例、Ⅱ型血腫6例、Ⅲ型血腫3例,Ⅰ型、Ⅱ型為少-中量出血,Ⅲ型為大量出血。結(jié)論:在臨床上對(duì)于急性腹直肌鞘血腫的診斷,腹部CT平掃能夠快速、準(zhǔn)確的明確RSH的診斷和分型,有助于指導(dǎo)治療,有利于患者的恢復(fù),具有臨床可行性。
[Abstract]:Objective: to evaluate the diagnostic value of plain abdominal CT scan in patients with acute rectus abdominis hematomas (RSHs). Methods: 20 patients with acute rectus abdominis hematoma confirmed by our hospital from April 2014 to April 2015 were selected. Material for retrospective analysis, Among the 20 patients, 12 received anticoagulant therapy and 5 received antiplatelet therapy. A total of 23 RSHs were found (3 of them were bilateral lesions, of which 10 were located in the upper abdomen and 13 in the lower abdomen. The CT plain scan of .RSH showed round, elliptical or irregular high-density shadows, located on the back of the rectus abdominis, and partly across the tendon. The size of hematoma above arcuate line is limited by the sheath of rectus abdominis, the volume of hematoma is smaller, rectus abdominis muscle is fusiform thickening, and the posterior layer of rectus abdominis sheath below arcuate line is replaced by weak transverse fascia and peritoneum. The hematoma tends to protrude to the pelvic side with small pressure. Among the 20 cases, 11 cases are type 鈪，

本文編號(hào)：1671050