5例自发性脾破裂误诊分析

目的：探讨自发性脾破裂误诊的原因，方法：回顾分析1986－1998年我院收治的8例自发性脾破裂的临床资料，结果误诊5例，误诊率62．5％，结论凡不明原因上腹部疼痛，伴有失血征象而无法解释、无外伤史，积极行B超、腹穿以明确。若有血吸虫、肝炎等肝脾病变或脾亢更应警惕本病，发病前有饱食或重体力劳动等腹压增高原因有助诊断。

Analysis of 5 cases of the misdiagnosis of spontaneous rupture of spleen

Objective To explore the causes of the misdiagnosis of spontaneous rupture of spleen.Methods 8 cases of spontaneous rupture of spleen during 1986～1998 were reviewed retrospectively.Results 5 cases were misdiagnosed, with the misdiagnosing rate of 62.5%.Conclusion For unknown upper bellyache accompanied with unexplainable loss of blood and with no history of trauma,the patients should be examined by B ultrasound or abdominal puncture should be peformed.If there is pathological process of liver and spleen such as schistosoma and hepatitis or the excessive functioning of spleen,the more attention should be paid to the occurrence of spontaneous rupture of spleen.Furthermore,the increase of the belly pressure caused by satiation or hard labour helps to diagnose such case.