腹部创伤定点超声检查在急诊腹部闭合性创伤的应用

目的总结腹部创伤定点超声（focussedassessmentsonographtrauma，FAST）检查在急诊科的应用价值。方法对76例腹部闭合性创伤的患者进行FAST检查，与腹部CT或手术探查结果进行比较，评价FAST检查对腹部闭合性创伤患者的快速诊断效能。结果FAST的敏感性90．7％，特异性69．7％，阳性预测值79．6％，阴性预测值85．2％，假阳性率30．3％，假阴性率9．3％，准确性81．6％。FAST检查平均用时（3．5±1．3）min，远优于CT检查的（29．1±12．5）min。两者差异有统计学意义（P〈0．05）。结论FAST检查法对腹部闭合性创伤患者具有快速评价诊断效能，可作为急诊医生判断腹部外伤患者是否存在腹部损伤的初步检查方法。

Effect of focussed assessment sonograph trauma on the diagnosis of patients with abdominal trauma

Objective To investigate the quickly diagnostic value of FAST（ Focussed Assessment Sonograph Trauma） in patients with abdominal trauma. Methods FAST was performed in 76 multiple traumaic patients, FAST examination results and exam time were compared with CT scan or exploratory lap- arotomy findings. Results Sensitivity is 90. 7% and Specificity is 69.7%, positive predictive value 79.6%, negative predictive value 85.2% ,false positive rate 30.3%, false negative rate 9.3% , Veracity is 81.6%. The average exam time by FAST （3.5 ~ 1.3 ） min is evidence precede CT （29. 1 _＋ 12.5 ） mino The difference has statistical significan（P 〈 0.05 ）. Conclusion FAST is useful as the initial diagnostic and monitoring tool for abdominal trauma to detect intra-abdominal trauma because of its high sensitivity for the detection of free fluid and its repeatability.