急诊超声对腹部创伤内脏破裂出血的价值

Value of emergency ultrasound in the hemorrhage of abdominal trauma visceral rupture

目的探讨急诊超声对腹部创伤内脏破裂出血的价值。方法收集我院腹部创伤内脏破裂出血的患者,根据患者手术结果分为:35例肝破裂组和65例脾破裂组。分析肝破裂组和脾破裂组超声显像特征;肝破裂组和脾破裂组超声显像结果与手术结果诊断符合率;肝破裂组和脾破裂组临床诊治结果。结果肝破裂组主要表现为实质形态不规则,实质内可见不均质低回声或无回声;脾破裂组主要表现为见血肿无回声区域强弱不均质低回声区存在,脾包膜连续性中断;肝破裂组和脾破裂组超声显像结果与手术结果诊断符合率分别82.85%、92.31%,比较差异无统计学意义(P>0.05);患者中仅3例死亡,主要原因为肝脏出血量过大,术后心肺功能衰竭。结论腹部创伤内脏破裂出血为临床急危重疾病,通过超声可以获得丰富的信息。

Objective To investigate the value of emergency ultrasound in the hemorrhage of abdominal trauma visceral rupture.Methods The patients with abdominal trauma and hemorrhage in our hospital were collected and divided into 35 cases of liver rupture and 65 cases of splenic rupture according to the outcome of the patient's operation.The characteristics of ultrasonography in hepatic rupture group and splenic rupture group were analyzed.The coincidence rate of ultrasonography and operative results in liver rupture group and spleen rupture group was compared with those in operation group,and the diagnosis and treatment results in liver rupture group and spleen rupture group were also analyzed.Results The liver rupture group showed substantial irregular parenchyma not homogeneous low echo or no echo;Splenic rupture group showed no regional presence of hematoma echo heterogeneity hypoechoic,and continuous rupture of spleen capsule;Diagnostic coincidence rate between ultrasonography findings and operative results in liver rupture group and splenic rupture group were 82.85%,92.31%,the difference was not statistically significant(P>0.05).3 cases died,the main reason for the excessive bleeding of liver,heart and lung failure after operation.Conclusion Hemorrhage of visceral rupture in abdominal trauma is a critical and critical clinical disease,and rich information can be obtained through ultrasound.