闭合性腹部损伤早期诊断和影像学探讨

Investigation on early diagnosis of blunt abdominal trauma and imaging discussion

目的探究闭合性腹部损伤的早期诊断方法以及影像学手段检测的特征性表现。方法选取我院收治的闭合性腹部损伤患者80例作为研究对象,回顾性分析患者的基本临床资料和影像学诊断资料,观察患者的主要临床症状、生命体征、总结其临床特点,分别计算B超、CT扫描以及腹部穿刺等方法的诊断阳性率,并对患者治疗后的结果进行分析。结果患者均以持续性腹痛为主要临床症状,56例患者有明显的创伤性休克和腹膜炎体征(占70.0%),其中以创伤性休克为主要体征的患者35例(占43.8%),21例患者以腹膜炎为主要体征(占26.2%)。对患者进行查体,还可见与外伤作用力点一致的位置存在腹部压痛、反跳痛、腹肌紧张等表现。患者经实验室检查,可见40例患者存在血红蛋白水平下降的情况(Hb<100 g/L),占50.0%,提示患者合并实质性脏器损伤。经腹腔穿刺检查,可见诊断阳性72例,阳性率为90.0%,经B超检查阳性74例,阳性率为92.5%,经CT检查,阳性74例,阳性率为92.5%。结论对闭合性腹部损伤的患者进行早期及时有效的诊断和治疗,掌握闭合性腹部损伤的临床特点,联合使用腹部穿刺和B超以及CT扫描等影像学检查手段,可以显著提高诊断的准确率,减少合并多发创伤的误诊和漏诊率,为其治疗提供可靠的依据,其也是治疗顺利进行,提高其临床疗效,降低治疗后并发症发生率的有效保障。

Objective To investigate the early diagnosis of blunt abdominal trauma imaging methods and means for detecting the characteristic features. Methods In our hospital,80 cases of blunt abdominal trauma patients as research subjects,retrospective analysis of clinical data and basic diagnostic imaging data were observed mainly in patients with clinical symptoms,vital signs,summarized the clinical features and imaging features. Calculate B ultrasound,diagnostic yield CT scan and abdominal puncture method,and analyzes the results of a patient after treatment. Results Patients with persistent abdominal pain were the main clinical symptoms,56 patients had obvious signs of traumatic shock and peritonitis,accounting for 70. 0%,which was mainly in patients with traumatic shock for signs of 35 cases,43. 8%,21 patients with peritonitis as the main signs,representing 26. 2%. Physical examination of the patient,but also showed the existence of a consistent position and force trauma abdominal tenderness,rebound tenderness,muscle tension and other symptoms.Patients with laboratory examination showed the presence of 40 patients decline in hemoglobin levels（ Hb 100 g / L）,accounting for 50. 0%,suggesting that the merger will slow substantial organ damage. After paracentesis examination showed positive diagnosis 72 cases,the positive rate was 90. 0%,after 74 cases of B-ultrasound positive,the positive rate was 92. 5%,the CT examination,74 cases positive,the positive rate was 92. 5%.Conclusions Patients with blunt abdominal injury timely and effective early diagnosis and treatment,to master the clinical features of blunt abdominal trauma,joint use of abdominal puncture and B super and CT scanning,may significantly improve the accuracy of diagnosis,reduce misdiagnosis and missed diagnosis rate combined with multiple trauma,provide a reliable basis for treatment,which is also the treatment carried out smoothly,improve the clinical efficacy and reduce the effective protection of the incidence of complications after treatment.