急危重症胸腹部创伤患者早期诊断中急诊床旁超声检查的作用  

The Role of Emergency Bedside Ultrasonography in Early Diagnosis of Patients with Acute and Severe Thoracic and Abdominal Trauma

作　　者：黄文源 潘磊 HUANG Wenyuan;PAN Lei(Department of Emergency,the Eighth People's Hospital of Panyu District,Guangdong 511400,China)

机构地区：[1]广东省广州市番禺区第八人民医院急诊科,广东511400

出　　处：《影像技术》2024年第5期26-29,44,共5页Image Technology

摘　　要：目的:评估急诊床旁超声检查应用在急危重症胸腹部创伤患者早期诊断中的作用。方法:纳入2022年2月—2024年2月广州市番禺区第八人民医院80例拟诊为急危重症胸腹部创伤患者,均行床旁超声、计算机断层扫描(CT)检查,参照手术结果,评价手术结果、诊断时间、诊断效能、诊断符合率。结果:80例疑似病例经手术确诊有71例为急危重症胸腹部创伤,并且发生率居于前四位的是创伤性胸腔积液(27.50%)、创伤性气胸(16.25%)、脾脏损伤(12.50%)、肝脏损伤(11.25%);较之CT,床旁超声诊断时间更短,P<0.05;床旁超声准确性为83.75%、特异性为66.67%、灵敏性为85.92%,与CT 91.25%、77.78%、92.96%无差异,P>0.05;床旁超声、CT在诊断急危重症胸腹部创伤患者具体损伤类型方面的符合率无差异,P>0.05。结论:床旁超声、CT在早期诊断急危重症胸腹部创伤时诊断效能、诊断符合率基本一致,不过前者诊断速度更快,更有助于快速、准确诊治急危重症胸腹部创伤患者,有临床借鉴意义。Objective:To evaluate the role of emergency bedside ultrasound in the early diagnosis of patients with acute and severe thoracic and abdominal trauma.Methods:From February 2022 to February 2024,80 patients with severe acute thoracic and abdominal trauma were included in the Eighth People's Hospital of Panyu District,Guangzhou.Bedside ultrasound and computed tomography(CT)were performed.The surgical results,diagnostic time,diagnostic efficiency and diagnostic coincidence rate were evaluated according to the surgical results.Results:(1)Of the 80 suspected cases,71 cases were diagnosed as acute and severe thoracic and abdominal trauma,and the top four were traumatic pleural effusion(27.50%),traumatic pneumothorax(16.25%),spleen injury(12.50%)and liver injury(11.25%).(2)Compared with CT,the diagnostic time of bedside ultrasound was shorter,P<0.05.(3)The accuracy,specificity and sensitivity of bedside ultrasound were 83.75%,66.67%and 85.92%,which were not different from those of CT 91.25%,77.78%and 92.96%,P>0.05.(4)There was no difference in the coincidence rate of bedside ultrasound and CT in the diagnosis of specific injury types in patients with acute and critical thoracic trauma,P>0.05.Conclusion:Bedside ultrasound and CT have the same diagnostic efficiency and diagnostic coincidence rate in the early diagnosis of acute and critical thoracic and abdominal trauma,but the former is faster in diagnosis,and is more helpful to the rapid and accurate diagnosis and treatment of acute and critical thoracic and abdominal trauma patients,and has clinical reference significance.

关 键 词：急危重症 胸腹部创伤 早期诊断 急诊 床旁超声 

分 类 号：R641[医药卫生—外科学]