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超声造影在腹部实质脏器创伤快速分类治疗中的价值
引用本文:吕发勤,唐杰,罗渝昆,李志艳,李俊来,黎檀实.超声造影在腹部实质脏器创伤快速分类治疗中的价值[J].中华医学超声杂志,2009,6(1):11-13.
作者姓名:吕发勤  唐杰  罗渝昆  李志艳  李俊来  黎檀实
作者单位:1. 解放军总医院超声科,北京,100853
2. 解放军总医院急诊科,北京,100853
基金项目:全军医药卫生科研基金 
摘    要:目的探讨超声造影在腹部实质脏器创伤快速分类治疗中的作用。方法对105例腹部实质脏器创伤患者的超声造影结果进行回顾性分析,并与CT和(或)手术结果进行对照。超声造影引导注射治疗的方法是在超声造影引导下,首先于肝、脾或肾创伤灶内多点注射蛇毒凝血酶,继之于肝、脾创伤灶和活动性出血部位多点注射旺一氰基丙烯酸酯黏合胶;保守治疗的方法是卧床休息、常规给予抗生素和补充血容量。结果在所有105例患者中,超声造影与增强CT两者诊断结果有很好的一致性(P〈0.001);在手术治疗的19例患者中,超声造影与手术诊断结果完全一致。在105例肝、脾、肾创伤患者中,保守治疗28例,超声造影引导注射治疗58例,手术治疗19例。保守治疗、超声造影引导注射治疗和手术治疗率分别为26.7%(28/105)、55.2%(58/105)和18.1%(19/105),非手术治疗率为81.9%(86/105)。结论通过超声造影对创伤伤情的分类,所有患者得到快速、安全和有效的治疗。

关 键 词:      创伤和损伤  造影剂  超声检查

The contrast-enhanced ultrasound for classification treatment of trauma of abdominal parenchymal organs
L Fa-qin,TANG Jie,LUO Yu-kun,LI Zhi-yan,LI Jun-lai,LI Tan-shi.The contrast-enhanced ultrasound for classification treatment of trauma of abdominal parenchymal organs[J].Chinese Journal of Medical Ultrasound,2009,6(1):11-13.
Authors:L Fa-qin  TANG Jie  LUO Yu-kun  LI Zhi-yan  LI Jun-lai  LI Tan-shi
Institution:L(U) Fa-qin,TANG Jie,LUO Yu-kun,LI Zhi-yan,LI Jun-lai,LI Tan-shi
Abstract:Objective The purpose was to retrospectively analyze the value of contrast-enhanced ultrasound in classification treatment of trauma of abdominal parenchymal organ. Methods One hundred and five patients with trauma of abdominal parenchymal organ, who received contrast-enhanced ultrasound, were retrospectively analyzed. The results of contrast-enhanced ultrasound were compared with those by CT or/and operation. The percutaneous injection treatment at bedside was carried out under the guidance of contrast-enhanced ultrasound: firstly, haemocoagulase was multi-point injected into the injury site of liver, spleen or kidney; then α-cyanoacrylate was injected into the injury and active hemorrhagic sites of liver or spleen. The conservative treatment was performed to stay in bed with application of intravenous fluid and proper antibiotics. Results In all 105 patients, the findings of contrast-enhanced ultrasound were consistent with those by CT scanning (P 〈 0. 001 ) and 19 cases received operative management, the findings of contrast-enhanced ultrasound were completely demonstrated by operation. In 105 cases, 26.7% (28/105) received conservative treatment, 55.2% (58/105) received early injection treatment under the guidance of contrast-enhanced ultrasound and 18.1% (19/105) received operation using rapid classification by bedside contrast-enhanced ultrasound. Conclusions By bedside contrast-enhanced ultrasound, the patients with trauma of abdominal parenchymal organ can be rapidly classified and treated.
Keywords:Liver  Spleen  Kidney  Wounds and injuries  Contrast media  Ultrasonography
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