急诊超声检查腹部创伤245例

The value of emergency sonography in the diagnosis of patients with abdominal trauma

目的探讨急诊超声在腹部创伤后定位诊断内脏损伤的价值。方法回顾分析急诊超声诊断并经手术或CT证实的腹部创伤所致内脏损伤245例。结果①245例共346个脏器损伤,超声确诊299例,误诊47例,总符合率为86.4%;②超声诊断脾、肝、肾及胃肠、肠系膜血管、膀胱、后腹膜脏器损伤等符合率分别为:93.4%、91.9%、80.9%及51.3%;③超声与手术比较检出腹腔积液及腹膜后血肿符合率分别为:100%(213/213)和89.5%(51/57)。结论急诊超声对腹部创伤后定位诊断脏器损伤具有较高临床诊断价值。

Objective To assess the value of emergency ultrasound in the diagnosis of patients with abdominal trauma. Methods Retrospective study was performed on 245 patients with abdominal trauma. All patients were examined with emergency ultrasound, and their sonographic findings were compared with their CT and operative findings. Results 1） Abnormal signs suggestive of injury were detected in 346 organs among 245 patients, and correct diagnosis was made in 299 cases, while misdiagnosis occurred in 47. The overall accuracy of sonographic diagnosis was 86.4 %. 2） The accuracy rate of sonographic diagnosis of various organs： for splecn, liver, kidney, mesentery, bladder, retroperitoneal injuries were 93.4%, 91.9%, 80.9% and 51.3% respectively. 3） The accuracy of sonography on the free fluid and retroperitoneal fluid were 100% （213/213） and 89.5% （51/57） respectively. Conclusion Emergency sonography to evaluate patients for injury caused by abdominal trauma is highly accurate.