急诊超声诊断闭合性腹部创伤内脏破裂出血198例分析  

Study of Emergency Ultrasound on the Diagnosis of 198 Patients with Visceral Rupture Bleeding Secondary to Blunt Abdominal Trauma

作　　者：蔡晓玲[1] 赵来友[1] 

机构地区：[1]广州市花都区人民医院超声科,广东广州510800

出　　处：《国际医药卫生导报》2004年第18期46-48,共3页International Medicine and Health Guidance News

摘　　要：　目的　 总结闭合性腹部创伤内脏破裂出血的声象图特征,探讨其急诊超声的诊断价值及规律,提高急诊超声诊断率。方法分析198例经手术证实的闭合性腹部创伤的急诊声像图特征。结果种类繁多的闭合性腹部创伤声像图共同特征为:直接征象:受损实质脏器轮廓线不连续,包膜中断,内部损伤区以不均质不规则混合回声为主,空腔脏器无节段性增厚及扩张。间接征象:1、受损脏器部位有探头压痛和反跳痛,受损侧膈肌运动比健侧减低。2、破裂的脏器周围大多有血凝块聚集或大网膜包裹。3、腹腔积液征象:暗区随体位移动;随探头压力改变;能勾画出脏器的轮廓;肠袢在液体中蠕动;下腹部纵切面“△”形暗区,尖端向下。4、空腔脏器破裂时腹腔内有游离气体存在。急诊超声对内脏破裂出血的定性检出率100%(198/198),定位符合率85%(168/198)。结论以上声像图特征对闭合性腹部创伤的急诊超声诊断具有独特价值,为其内脏破裂出血的定性及定位诊断提供可靠性依据。Objective To study the ultrasonographic characteristics of visceral rupture bleedingsecondary to blunt abdominal trauma and to find out diagnostic criteria Of emergency ultrasound.Methods The emergency ultrasound features of 198 cases confirmed by operation were analyzed. ResultsThe different kinds of organ injury there were ultrasonic imaging characteristics. Direct characteristics:Outline of injured parenchyma organ was broken, irregularity beterojeneity imaging appeared injuredarea . Injured cavity organ had no phase expansion and pachynsis. Indirect haracteristics: (1) Presenceof tenderness when probe was pressed on the affected side; motion of the trauma side diaphragm wasreduced;(2) Sheetlike or irregular echogeitc clots or hematomas surrouding ruptured organs,or theruptured organs surrounded by greater omentum;were shown;(3) Intraperitoneal fluid characteristics:①Mobile with patient shifted;②Compressed with probe pressure;③organ margins Contoured;④Bowel loops moved with fluid ⑤Triangular shape of dark area with apex inferiorly in saglttal view.Thedetected ratio of visceral rupture bleeding was 100%(198/198),the coincidence rate of localitzationwas 86%(168/198). Conclusions The ultrasonic imaging characterlstics had specilfic valuation foremergency ultrasound diagnosis of intra bdomlnal injury,it provide scientific foundation for quality andsituation of ovisceral rupture bleeding.

关 键 词：急诊超声 闭合性腹部创伤 内脏破裂出血 声象图特征 

分 类 号：R656.1[医药卫生—急诊医学]