Lawson D E, Jacobson J A, Spizarny D L, Pranikoff T
Department of Diagnostic Radiology, Henry Ford Hospital, Detroit, Mich.
Radiology. 1995 Jan;194(1):97-100. doi: 10.1148/radiology.194.1.7997589.
To determine the value of follow-up computed tomography (CT) after expectant treatment in patients with clinically stable blunt splenic trauma.
Medical records and CT studies for 42 patients were reviewed, and injuries were graded on a scale of 1-6. Patients were divided into three groups: stable patients with no follow-up CT (group 1, n = 14), stable patients with follow-up CT (group 2, n = 22), and symptomatic patients with follow-up (group 3, n = 6). Serial hemoglobin values and clinical findings at follow-up CT were reviewed.
All patients in groups 1 and 2 remained clinically stable with good outcomes. In group 3, follow-up CT scans demonstrated worsening condition in four patients (67%), and three of the four had poor outcomes.
Follow-up CT may be unnecessary in patients with clinically stable splenic trauma.
确定临床稳定的钝性脾外伤患者在保守治疗后进行随访计算机断层扫描（CT）的价值。
回顾了42例患者的病历和CT检查结果，并根据1-6级对损伤进行分级。患者分为三组：未进行随访CT的稳定患者（第1组，n = 14）、进行随访CT的稳定患者（第2组，n = 22）和进行随访的有症状患者（第3组，n = 6）。回顾了随访CT时的系列血红蛋白值和临床检查结果。
第1组和第2组的所有患者临床均保持稳定，预后良好。在第3组中，随访CT扫描显示4例患者（67%）病情恶化，其中4例中有3例预后不良。
临床稳定的脾外伤患者可能无需进行随访CT检查。
