腹部CT平扫对急性腹直肌鞘血肿的诊断价值

发布时间：2018-03-27 09:54

  本文选题：腹部CT平扫　切入点：急性腹直肌鞘血肿　出处：《中国农村卫生》2017年02期

【摘要】：目的:探讨腹部CT平扫对急性腹直肌鞘血肿(RSH)的诊断价值。方法:选择我院2014年4月到2015年4月经临床证实的20例急性腹直肌鞘血肿患者的CT平扫图像及临床资料进行回顾性分析,并进行统计学分析。其中20例患者中接受抗凝治疗的有12例,抗血小板治疗的5例。结果:经过分析后,20例腹部CT平扫均正确诊断,共发现23处RSH(其中3例为双侧发病),其中位于上腹部10处、下腹部13处。RSH的CT平扫表现为圆形、椭圆形或不规则形高密度影,位于腹直肌的背部,部分可跨越腱划,其形态与其发生的位置有关,弓状线以上的血肿由于受到腹直肌鞘的限制,血肿体积多较小,腹直肌呈梭形增粗,弓状线以下腹直肌鞘后层由薄弱的腹横筋膜及腹膜替代,血肿易向压力较小的盆腔侧突出,血肿多较大。20例中Ⅰ型血肿11例、Ⅱ型血肿6例、Ⅲ型血肿3例,Ⅰ型、Ⅱ型为少-中量出血,Ⅲ型为大量出血。结论:在临床上对于急性腹直肌鞘血肿的诊断,腹部CT平扫能够快速、准确的明确RSH的诊断和分型,有助于指导治疗,有利于患者的恢复,具有临床可行性。
[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，

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