创伤超声重点评估法在急诊及野战条件现场救治中的应用价值  

Value of FAST (Focused assessment with sonography for trauma) for medical treatment in emergency and in field operation

作　　者：高海港[1] 董晓明[1] 苏光明[1] 黎颖[1] 祝莉[1] 孙浩[1] 

机构地区：[1]解放军第477医院特诊科,湖北襄阳441003

出　　处：《临床军医杂志》2011年第4期748-751,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨创伤超声重点评估法(FAST)在急诊救治中和野战条件下现场医疗救治中的应用价值。方法 (1)在医院急诊中,对195例外伤患者进行FAST检查,以发现腹腔游离积液和腹腔内实质脏器损伤为阳性,并与其他检查或手术结果进行对照分析。(2)将FAST检查应用于野战医疗队集训演习中,总结在野战条件下的应用价值和策略。结果(1)①急诊中24例阳性发现,19例腹腔中大量积血(液),均行急诊手术。术后证实均为内脏实质脏器破裂伴腹腔积血,符合率100%;5例发现肾破裂伴肾周血肿,未行急诊手术,后经CT检查证实。②3例发现假阳性。③5例发现假阴性。(2)野战条件下应做到:①更易展开、撤收的便携性超声仪及相关设备。②检查组成员须经专门培训。③须行扩展性FAST检查及后续性FAST检查。结论 FAST检查对于腹腔积血须急诊手术者具有高度敏感性和特异性,且环境要求低,检查用时短,特别在野战条件下对大批伤员的快速诊断、检伤和分类中有很大应用价值。Objective To evaluate the application of FAST（Focused Assessment with Sonography for Trauma） for medical treatment in special field and in hospital emergency.Methods（1） 195 trauma patients have been treated in emergency treatment of hospital.They were concluded to be positive by detecting free intraperitoneal cavity effusion and trauma in intraperitoneal organ in FAST.And have comparative analysis between FAST and other detecting operation consequences.（2） Evaluate FAST and conclude strategy in field operation,by utilizing it in field medical team.Results（1） ①Out of 24 positive cases,19 cases is serous intraperitoneal cavity effusion,in which emergency operations are required.They are proved to 100% accurate after operations,in which patients are diagnose to be intraperitoneal organ trauma accompanying bematoperitoneum;5 cases are detected to be rupture of kidney accompanying perirenal hematoma.They haven＇t got emergency operation and confirmed by CT.② Three false-positive cases.③ Five false-negative cases.（2）In field operation,we should focus on： ① more portable ultrasound instruments and relative instruments for expending and folding,② special training for examiners,③ extended and subsequent FAST.Conclusion FAST has highly sensitivity and specificity for serous intraperitoneal cavity effusion patients who require emergency operation.It requires simple environmental demand,short detecting period and has huge application value in field operation,which require timely diagnose,trauma-detecting and category for a large number of patients.

关 键 词：野战条件 创伤超声重点评估法 创伤 分类 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]