超声检测技术在深度电烧伤诊断中的应用

The application of ultrasonography in the diagnosis of deep electric injury

目的 探讨超声检测技术在深度电烧伤诊断中的应用价值。 方法 以 12例深度电烧伤患者 2 5个患肢的创面及创面近心端 5～ 15cm处为对象 ,采用彩色及脉冲多普勒超声检测技术 ,观察该处皮下组织、肌肉组织及血管的损伤情况 (共检测血管 5 6条 ) ,得出血流动力学定量指标。 结果 ( 1)经二维超声检测 ,深度电烧伤后各种组织的受损范围不同 :血管 >肌肉组织 >皮下组织 ;创面段血管内膜未显示者 7条 ,内膜水肿者 12条 ,管腔闭塞者 4条 ,血栓形成者 5条。 ( 2 )彩色多普勒检出 ,受测部位血管走行变异屈曲者共 12条 ,管腔狭窄者 2 1条 ,管腔增宽者 11条 ,均与随后手术治疗时所见情况一致。 ( 3)脉冲多普勒检出 ,狭窄段血管收缩期峰值流速增高 ,每分血流量减低。 结论 超声检测技术具有无创的特点 ,可直观地显示深度电烧伤后皮下组织、肌肉组织、血管的形态学改变 ,以利准确判断损伤程度 ,了解受损部位的血流动力学变化 ,为临床诊治提供依据。

Objective To explore the application of ultrasonography in the diagnosis of deep electric injury. Methods HP-IPHX high resolution color and pulse doppler ultrasnography was employed in the study. The hemodynamic indices were determined in the burn wound area and tissues 5-15 cm proximal to the wound in 12 patients with deep electric injury. At the same time,injuries to subcutaneous and muscular tissue and blood vessels (fifty-six blood vessels detected) were detected. Results 1.It was found by two-dimentional ultrosonography that the injury degree in different tissue after deep electric injury was different,i.e.blood vessels were most liable to injury followed by muscles and subcutaneous tissue. In the burn wound area,endothelium was not visuarized in 7 blood vessels and endothelial swelling was identified in 12 blood vessels.Furthermore,vascular occlusion was found in 4 blood vessels and thrombosis found in 5 vessels.2.It was also demonstrated by color ultrasonography that change in course of blood vessel and tortuesity were observed in 12 blood vessels,stenasis of lumen in 21 vessels and widened intravascular space in 11 vessels,All these findings were confirmed in the subsequent operations.3.It was revealed by pulse Doppler that the top blood flow speed increased during vascular contraction period in narrowed blood vessels with decreased blood flow per minute. Conclusion Being an non-invasive examination,ultrasonography could directly demonstrate the morphological changes in subcutaneous tissue,muscle and blood ressels after a deep electric injury,which might help determine the injury degree and the hemodynamic changes in the injured site. [