超声造影在诊断腹部实质脏器损伤及引导微创止血治疗中的作用

Role of contrast-enhanced ultrasound in the diagnosis and guidance for minimally invasive hemostasis therapy of blunt abdominal trauma

目的探讨超声造影在诊断腹部实质脏器损伤及引导微创止血治疗的价值。方法对临床疑为肝脾破裂的患者行超声造影检查，并对损伤程度进行分级。根据超声造影和cT诊断结果，对损伤程度为3～4级、生命体征平稳的患者行超声造影引导下微创止血治疗。结果48例患者中35例超声造影确诊为实质脏器损伤，均经手术或cT证实。11例患者成功在超声造影引导下进行了肝脾脏器的微创止血治疗，治疗中和治疗后无明显不适。结论超声造影可准确诊断肝脾损伤并判断程度，其引导的微创止血治疗对生命体征平稳的患者可实现安全、有效的止血，是非手术治疗的一种良好方法。

Objective To investigate the clinical value of contrast-enhanced ultrasound （CEUS） in the diagnosis and guidance for minimally invasive hemostasis therapy of blunt abdominal trauma. Methods CEUS was performed among the patients with hepatic or splenic trauma and the traumatic degrees were evaluated. According to the results of CEUS and CT scanning, patients with grade Ⅲ-Ⅳ AAST organ injury and steady vital sign were treated with CEUS guided minimally invasive hemostasis therapy. Results Among the 48 patients, 35 of them with solid organ trauma were diagnosed by CEUS and were confirmed by CT scanning and operation. Eleven patients were cured by interventional therapy under the guidance of CEUS successfully.Conclusion CEUS can diagnose the blunt trauma in abdominal organs and evaluate the traumatic degrees.The hemostasis therapy guided by CEUS is safe and effective for patients with steady vital sign, and can be a good alternative for non- operative treatment.