微创介入方舱内超声检查在血管损伤猪模型诊治中的应用

Ultrasonography Application in Diagnosis of Vascular Injury in Swines in a Mobile Combat Medical Cabin

目的探讨便携式超声检查在野战介入方舱快速诊治血管损伤中的价值及作用。方法在野战介入方舱内对10只健康成年猪通过血管介入建立腹部脏器血管损伤的动物模型,应用便携式超声分别探查造模前、造模后即刻、10、30 min损伤部位的超声影像图变化,并与血管造影比较。结果 10只实验猪共造成10处血管损伤,造模前超声显示肝、脾、肾形态正常、结构清晰,造模后即刻、10、30 min超声和血管造影分别检出2、5、7只形成血肿和10、8、6只造影剂外渗;超声诊断率分别为20.0%、50.0%、70.0%,血管造影诊断率分别为100.0%、80.0%、60.0%。结论便携式超声检查对外伤所致的血管损伤具有较高的检出率,可以作为战场一线野战介入方舱内血管损伤快速诊治的首选筛查手段,并为后续治疗提供指导。

Objective To explore the value and effect of portable ultrasonographic unit in quick diagnosis of vascular injury in a traveling medical cabin in war-time situations conditions. Methods Models of vascular injury of abdominal organs were established in 10 healthy adult swines in a traveling medical cabin, and changes of vascular injury were checked with a portable ultrasonographic unit before modeling and 0, 10 and 30 minutes after modeling. The ultrasonography results were compared with those by angiography. Results Ten vascular injuries were successfully established in ten swines. The liver, spleen and kidney were normal in ultrasonography before modeling. Hematomas were found in 2, 5 and 7 cases respectively by ultrasonography, and extravasation of contrast media were found in 10, 8 and 6 cases respectively by angiography 0, 10 and 30 minutes after modeling; ultrasonic diagnosis rates were 20. 0% , 50. 0% and 70.0% , while angiography diagnosis rates were 100.0% , 80.0% and 60. 0% respectively. Conclusion The detection rate of the portable ultrasonographic unit in diagnosis of vascular injury induced by traumas is high in a traveling medical cabin, and can be used as the preferred choice in diagnosis of vascular injuries in war time situation, which can provide guidance for further treatment.