探讨CT对闭合性腹腔内出血量的量化评估  

Hemoperitoneum studied by computed tomography for blunt abdominal trauma

作　　者：陈淑香[1,2] 杜瑞宾 CHEN Shuxiang;DU Ruibin(Fujian Province Hospital South Branch,Fuzhou 350028,China;Clinical Medicine College of Fujian Medical Univesity,Fuzhou 350000,China)

机构地区：[1]福建省立医院南院,福建福州350028 [2]福建医科大学省立临床医学院,福建福州350000

出　　处：《临床医药实践》2021年第1期41-44,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨急诊CT对腹部闭合性创伤内出血量评估的准确性,为临床诊疗提供参考。方法:回顾性分析经手术证实的40例资料完整的腹腔内出血患者的临床及影像资料,对比CT测量计算的出血量及按腹腔积血间隙、休克指数估计的腹腔内出血量与手术结果的相关性。结果:术中收集的腹腔出血量高于通过CT测量计算及按腹腔间隙、休克指数估算的出血量,差异有统计学意义(P<0.05),其中以CT测量计算的腹腔内出血量更接近术中收集的量,且其与腹腔间隙、休克指数估算的腹腔内出血量比较差异有统计学意义(P<0.05);而腹腔间隙与休克指数估算的腹腔内出血量比较差异无统计学意义(P>0.05)。结论:CT测量计算评估腹腔内出血量较腹腔间隙、休克指数估算等临床评估方法更准确,更接近手术结果,并可明确积血位置、协助判断出血来源,为临床医生进行诊疗决策提供参考,甚至避免不必要的剖腹手术。Objective:To evaluate the accuracy of CT in estimating hemoperitoneum in blunt abdominal trauma.Methods:Clinical and imaging data of 40 patients with hemoperitoneum confirmed by surgery were retrospectively analyzed.The correlation between the extent of hemoperitoneum calculated by CT measurement,abdominal space,shock index and the results of operation was compared.Results:The hemoperitoneum of surgical finding was higher than that estimated by CT measurement,abdominal space and shock index,the difference was statistically significant(P<0.05).Among them,the hemoperitoneum estimated by CT measurement was closer to that collected during the operation,and the difference with which estimated by abdominal space and shock index was statistically significant(P<0.05).While there was no statistically significant difference between hemoperitoneum estimated by the abdominal space and shock index(P>0.05).Conclusion:CT estimates of the extent of hemoperitoneum correlated well with clinical assessments and surgical finding.CT is sensitive and specific for the diagnosis of hemoperitoneum than which estimated by abdominal space and shock index and can estimate the extent and probable source of bleeding.This information may obviate the need for a peritoneal lavage and laparotomy in many instances.

关 键 词：腹腔内出血 闭合性腹部创伤 休克指数 

分 类 号：R445[医药卫生—影像医学与核医学]