超声检查对腹部闭合性损伤脏器破裂的诊断价值

腹部损伤在平时和战时都较多见，其发病率在平时约占各种损伤的0．4％～1．8％，多数腹部损伤因涉及内脏而伤情严重，死亡率高达10％～20％。腹部闭合性损伤常发生于挤压、碰撞等钝性暴力之后，因体表无伤口，要确定有无内脏损伤，有时是很困难的。随着超声检查技术的不断提高，腹部损伤     

超声诊断急诊腹部闭合性损伤内脏破裂出血临床应用

超声检查对于急性腹部闭合性损伤内脏破裂出血的诊断具有重要意义[1～4]。本文探讨超声应用于急诊腹部闭合性损伤内脏破裂出血诊断的临床价值。1材料与方法本组96例患者,其中男62例,女34例,年龄23～49岁,平均36.7岁。患者均有明确的外伤史,手术均证实为闭合性腹部损伤内脏破裂出血,其中交通事故37例,坠落伤34     

B超诊断腹部闭合性损伤的临床价值分析

腹部闭合性损伤临床表现多种多样,因此,必须密切观察,反复检查,妥善处理,以免延误诊断和治疗。本文收集2009年8月～2011年2月来我院接受超声检查与治疗的96例腹部闭合性损伤患者的临床诊断资料进行了回顾性分     

腹部闭合性脏器损伤的超声诊断

本研究回顾性总结了我院 1999 0 6～ 2 0 0 0 0 6经手术治疗( 3 8例 )或保守治疗 ( 10例 )的 48例腹部闭合性脏器损伤患者超声表现。1　材料和方法本组 48例均为外科急诊住院患者 ,男 40例 ,女 8例 ,年龄 8～ 5 9岁 ,平均 3 3岁。其中肝破裂 8例 ,脾破裂 15例 ,肾破裂 8例 ,肾挫伤 4例 ,胃肠道破裂 9例 ,膀胱破裂 2例 ,胰腺破裂 2例。B超检查时间从伤后 3 0分钟到 72小时。绝大多数在 12小时之内。使用HP尖端影像彩色超声仪、本田 2 0 0 0便携式超声仪 ,探头频率 3 .5MHz。嘱患者平卧位、侧卧位 ,对腹部行多切面检查。2　结果48例患者中 …     

B超在腹部闭合性损伤诊断中的应用价值分析

目的 探讨B超检查在腹部闭合性损伤中的诊断价值.方法 回顾性分析我院2004年01月～2010年01月住院治疗并经手术证实的腹部闭合性损伤患者102例的B超检查情况,分析B超检查其对腹部闭合性损伤的诊断价值.结果 102例患者中,B超检查诊断与手术结果符合86例,诊断符合率为84.3%.不符合16例,占15.7%.结论 B超检查在对腹腔闭合性损伤有较好的诊断价值.     

急诊床旁超声在腹部脏器闭合性损伤诊断中的应用价值

目的 探讨急诊床旁超声检查对腹部闭合性损伤的诊断应用价值.方法 应用便携式超声仪对184例外伤患者行急诊床旁超声检查,观察腹部脏器声像图有无异常改变,并重视观察腹腔内有无游离液体及气体.结果 超声诊断总符合率91.8%(169/184),其中单脏器损伤156例,符合率95.5%(149/156),多脏器损伤28例,符合率71.4%(20/28),漏诊21例,误诊3例,漏、误诊率13%(24/184).手术治疗119例;保守治疗65例,经CT、MRI检查及临床保守治疗证实.结论 急诊床旁超声检查对腹部闭合性损伤的诊断符合率高,为临床提供迅速、可靠的诊断信息.     

急诊床旁超声在腹部脏器闭合性损伤诊断中的应用价值

目的 探讨急诊床旁超声检查对腹部闭合性损伤的诊断应用价值.方法 应用便携式超声仪对184例外伤患者行急诊床旁超声检查,观察腹部脏器声像图有无异常改变,并重视观察腹腔内有无游离液体及气体.结果 超声诊断总符合率91.8%(169/184),其中单脏器损伤156例,符合率95.5%(149/156),多脏器损伤28例,符合率71.4%(20/28),漏诊21例,误诊3例,漏、误诊率13%(24/184).手术治疗119例;保守治疗65例,经CT、MRI检查及临床保守治疗证实.结论 急诊床旁超声检查对腹部闭合性损伤的诊断符合率高,为临床提供迅速、可靠的诊断信息.     

急诊床旁超声在腹部脏器闭合性损伤诊断中的应用价值

目的 探讨急诊床旁超声检查对腹部闭合性损伤的诊断应用价值.方法 应用便携式超声仪对184例外伤患者行急诊床旁超声检查,观察腹部脏器声像图有无异常改变,并重视观察腹腔内有无游离液体及气体.结果 超声诊断总符合率91.8%(169/184),其中单脏器损伤156例,符合率95.5%(149/156),多脏器损伤28例,符合率71.4%(20/28),漏诊21例,误诊3例,漏、误诊率13%(24/184).手术治疗119例;保守治疗65例,经CT、MRI检查及临床保守治疗证实.结论 急诊床旁超声检查对腹部闭合性损伤的诊断符合率高,为临床提供迅速、可靠的诊断信息.     

超声与常规CT在腹部闭合性损伤中的临床诊断价值

【摘要】 目的 探讨超声与常规CT 在腹部闭合性损伤中的诊断价值。方法 选取2019 年2月至2020年3月安阳县人民医院收治的64例腹部闭合性损伤患者作为研究对象,所有患者均接受超声及常规CT检查,对比观察两种检查方式对创伤类型的诊断准确率、创伤分级的判定符合率及诊断耗费时间。结果 超声检查诊断肾挫裂伤、肝挫裂伤、脾挫裂伤的准确率分别为91.67%、82.61%、95.12%,明显高于常规CT检查的诊断准确率50.00%、52.17%、80.49% (χ2=5.042、4.847、4.100,P =0.025、0.028?0.043);诊断腹腔积液的准确率为93.75%,明显低于常规CT检查的诊断准确率100%(χ2=4.129,P=0.042)。超声检查对Ⅰ级、Ⅱ级、Ⅲ级及以上脏器损伤程度的判定符合率为90.00%、90.91%、100%,均明显高于常规CT检查的判定符合率60.00%、60.61%、54.55% (χ2=4.800、5.639、6.471,P = 0.028、0.018?0.011)。超声检查的检查前时间、获得结果时间及总时间均明显短于常规CT检查(t =19.212、31.339、39.199,P均<0.001),而检查过程时间明显长于常规CT检查(t =11.556,P <0.001)。结论 超声检查对肝、肾、脾等实质性脏器损伤的诊断准确率更高,且检查时间较短,能够为救治患者争取更多宝贵时间。     

Abdominal sonography in examination of children with blunt abdominal trauma

OBJECTIVE: The objective of our study was to evaluate abdominal sonography for the detection of fluid and organ injury in children with blunt abdominal trauma. SUBJECTS AND METHODS: Fifty-one consecutive children with blunt abdominal trauma requiring abdominal CT were prospectively examined with sonography. Sonograms and CTs were independently evaluated by two radiologists for fluid and organ injury; CT examinations were considered abnormal if either was identified. Differences in CT interpretation were settled by a third observer. Using CT as the truth standard, we calculated the sensitivity, specificity, and negative predictive value of sonography for both observers. Agreement of the sonographic interpretations was evaluated using kappa statistic. RESULTS: In 33.3% of patients, CT revealed fluid, organ injury, or both. The sensitivity and specificity of sonography when detection of fluid was the sole parameter evaluated was 58.8% and 79.4%, respectively, for observer 1 and 47.1% and 79.4%, respectively, for observer 2. In contrast, the sensitivity and specificity of sonography when detection of both fluid and organ injury was evaluated was 64.7% and 79.4%, respectively, for observer 1 and 70.6% and 70.6%, respectively, for observer 2. The negative predictive value of sonography was 79.4% and 75.0% with evaluation limited to detection of fluid and 81.8% and 82.8% with evaluation of fluid and organ abnormality for observers 1 and 2 , respectively. Agreement was excellent for sonographic identification of fluid (kappa = 0.82) but poor for detection of organ injury (kappa = 0.34). CONCLUSION: The low sensitivity and negative predictive value of sonography when assessing for either fluid alone or fluid and organ injury suggest that a normal screening sonography alone in the setting of blunt abdominal trauma fails to confidently exclude the presence of an intraabdominal injury.     

增强CT对腹部实质脏器损伤的诊断价值

目的：探讨增强CT扫描检查对腹部实质脏器损伤的诊断价值。方法：回顾性分析63例经手术、血管造影及CT随访证为腹部钝性损伤病人的平扫及增强CT表现征象,并比较分析各种征象的作用。结果：本组63例中,11例（2例脾损伤,3例肝损伤,6例肾损伤）平扫换明显异常,增强CT扫描呈明显的低工改变;11例器官内或周围斑点状造影剂外渗,提示为活动性出血;29例增强 CT扫描后清楚显示裂伤部位,结论：增强CT检查对肝肾损伤的诊断明显优于平扫,还可以判断有无活动性出血等情况,对损伤程度的判断和治疗方案的制定较平扫更有价值。     

CT diagnosis of unsuspected pneumothorax after blunt abdominal trauma

Review of abdominal CT scans for evaluation of blunt abdominal trauma yielded 35 cases of pneumothorax, 10 of which had not been diagnosed before CT by clinical examination or plain radiographs. Of the 10 cases initially diagnosed on CT, seven required tube thoracostomy for treatment of the pneumothorax. CT detection of pneumothorax is especially important if mechanical assisted ventilation or general anesthesia is used. Demonstration of pneumothorax requires viewing CT scans of the upper abdomen (lower thorax) at lung windows in addition to the usual soft-tissue windows.     

Prospective evaluation of handheld ultrasound in the diagnosis of blunt abdominal trauma

OBJECTIVES: To evaluate the Sonosite 180 handheld ultrasound in the diagnosis of haemoperitoneum in blunt abdominal trauma. METHODS: Trauma ultrasound using the Focused Assessment with Sonar for Trauma (FAST) technique was performed using the Sonosite 180 handheld ultrasound during the primary survey of adult patients triaged to the resuscitation room with multiple trauma or suspected abdominal injury. The ultrasound findings were compared against the investigation of choice of the attending surgeon/accident & emergency physician--CT, DPL, laparotomy or clinical observation. RESULTS: 50 patients who had sustained blunt abdominal trauma were evaluated using FAST. Satisfactory images were obtained in 96%. There were 5 true positive scans confirmed by CT, DPL or laparotomy. There were no false negative or false investigations. The sensitivity and specificity of handheld FAST was 100%. CONCLUSIONS: Handheld ultrasound using the Sonosite 180 system can be successfully used by appropriately trained doctors as the primary investigation in the acute evaluation of blunt abdominal trauma.     

闭合性腹膜内型膀胱破裂的CT诊断

目的　确定闭合性腹膜内型膀胱破裂的CT诊断价值。方法　对 9例闭合性腹膜内型膀胱破裂的CT资料和临床处理进行回顾性分析。结果　所有 9例腹膜内型膀胱破裂 ,CT均明确诊断。CT显示腹膜腔内低密度液体积聚 9例 ,其CT值比血液低 ,主要分布在膀胱侧隐窝、盆腔陷凹、结肠旁沟、肝脾周围和肠袢内。膀胱壁局部缺损 3例 ,泪滴状变形 2例 ;其他支持膀胱破裂的CT征象包括 :膀胱充盈不良 8例 ,膀胱壁挫伤 4例 ,膀胱内血凝块 6例。结论　在创伤情况下 ,腹膜腔内出现CT值比血液小的低密度液体积聚 ,强烈提示尿外渗 ,根据尿外渗的分布范围 ,CT还可以区别腹膜内和腹膜外型膀胱破裂。CT有时还可以观察到膀胱破裂的准确位置 ,有利于手术修补     

多层螺旋CT诊断急性腹部闭合性外伤的临床价值

收集我院2009年9月～2011年8月经多层螺旋CT检查及手术证实急性腹部闭合性外伤58例患者临床资料,探讨多层螺旋CT诊断急性腹部闭合性外伤的临床价值。1材料与方法本组58例患者,其中男性47例,女性11例,年龄7～79岁,平均43岁。患者均有明确外伤史,其中车祸伤42例、