急诊超声检测腹腔积液在腹部闭合性损伤诊疗中的意义

Significance of peritoneal effusion detection by emergency ultrasound in closed abdominal injury

目的探讨急诊超声检测腹腔积液在腹部闭合性损伤诊疗中的意义。方法回顾性分析2006年8月至2009年6月就诊的212例腹部闭合性损伤患者的临床资料，系统评估急诊超声检测腹腔积液出现情况。结果212例患者中，腹腔积液出现率为78．8％（167／212），同期常规行诊断性腹腔穿刺的阻性率为46．2％（98／212）。床头超声随访，13例空腔脏器破裂和1例肾破裂患者出现腹腔积液。17例超声随访发现腹腔积液量增加。超声检查有腹腔积液患者，实质脏器损伤定位符合率为78．3％（112／143），空腔脏器损伤定位符合率为36．1％（13／36）。结论在腹部闭合性损伤诊疗过程中，常规应用超声检测腹腔积液，可有效降低漏诊率，避免延误治疗。

Objective To discuss the diagnostic value of peritoneal effusion detection by emergency ultrasound in patients with closed abdominal injury. Method From August 2006 to June 2009,212 patients with closed abdominal injury were studied to evaluate peritoneal effusion detection by emergency uhrasound. Results Of 212 patients,peritoneal effusion frequency rate was 78.8%（167/212）, meanwhile,abdominal paracentesis confirmation ratio was only 46.2% （98/212）. In the follow-up, 13 patients with injuried hollow viscera and 1 patient with rupture of kidney showed peritoneal effusion. The volume of abdominal fluid was increasing in 17 patients,which needed to be managed by surgery. The accuracy rates were respectively 78.3% （112/143 ） and 36.1% （13/36） in the solid organs and the hollow organs. Conclusion During the course of diagnosis and treatment in closed abdominal injury, peritoneal effusion monitoring by ultrasound should be used routinely, which can help to decrease the rate of misdiagnosis and avoid delayed treatment.