创伤重点超声评估法在胸腹部创伤急诊中的应用研究  

Application of traumatic stress ultrasound assessment method in emergency treatment of thoracic and abdominal trauma

作　　者：侯任昉[1] 李和莅[1] HOU Ren-fang;LI He-li(Chengdu Second people＇s Hospital , ChengduSichuan , 610017 , China)

机构地区：[1]成都市第二人民医院,四川成都610017

出　　处：《中国地方病防治》2018年第3期331-331,333,共2页Chinese Journal of Control of Endemic Diseases

基　　金：四川省卫生厅科研课题(编号:110049)

摘　　要：目的研究创伤重点超声评估法(FAST)在胸腹部创伤急诊中的应用价值。方法 92例胸腹部创伤患者均采取FAST、常规彩超检查,明确腹腔内实质性脏器损伤、胸腹腔、心包游离积液情况,以手术结果为金标准,比较FAST、常规彩超检查时间与阳性检出率,并分析FAST诊断价值。结果 FAST检查时间短于常规超声检查(P<0.05);经手术结果证实,92例胸腹部创伤患者,13例为阳性(14.13%);FAST检查11例阳性,其中6例为腹腔存在大量或中等量游离积液,2例为胸腔存在游离积液、积气,2例为肾破裂伴肾周血肿,1例为心包积血,均经手术结果证实;漏诊2例经手术证实为实质性脏器损伤,无误诊。结论急诊胸腹部创伤患者采取FAST检查,具有敏感度、特异度、准确度高、检查时间短等优势,可准确、快速判断胸腹部创伤情况,为临床评估病情、制定治疗方案提供信息支持。Objective To explore the application value of traumatic stress ultrasound assessment method（ FAST） in emergency treatment of thoracic and abdominal trauma.Methods 92 patients with thoracic and abdominal trauma were examined by FAST and conventional color Doppler ultrasound.The substantive visceral injury,thoracic and abdominal cavity,and pericardial free effusion in the abdominal cavitywere found out.Taking the outcome of the operation as the gold standard,the examination time and positive detection rate of FAST and routine color Doppler ultrasound were compared,and the diagnostic value of FAST was analyzed.Results The examination time of FAST was shorter than that of the routine ultrasound examination（ P0.05）.13 cases were positive in 92 cases of thoracic and abdominal trauma（ 14.13%）.The FAST examination showed that 11 cases were positive of which 6 cases were abdominal cavity with large or medium free effusion,2 cases were free of pleural effusion and gas accumulation,2 cases of renal rupture with pericenal hematoma,and 1 case of pericardial hematoma,allconfirmed by the operation,2 cases of missed diagnosis were confirmed by operation as substantive visceral injury, but no misdiagnosis was found.Conclusion The patients with thoracic and abdominal trauma examined by FAST has the advantages of high sensitivity,specificity,accuracy and short examination time.It can accurately and quickly judge the situation of thoracic and abdominal trauma,and provide information support for clinical evaluation and treatment.

关 键 词：急诊 胸腹部创伤 创伤重点超声评估法 

分 类 号：R641[医药卫生—外科学]