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便携式超声创伤重点评估检查对急诊腹部闭合性损伤患者的诊断价值
基金项目:浙江省医药卫生科技计划项目(2019ZH065)
摘    要:目的 探究便携式超声创伤重点评估(FAST)检查在急诊腹部闭合性损伤患者中的诊断价值。方法 回顾性分析丽水市人民医院急诊科2018 年6 月~2020 年1 月收治的78 例腹部闭合性损伤患者临床资料,78 例患者均采用Mindray 公司的M9 便携式超声诊断仪进行腹部扫描检查,以手术结果或临床诊断为最终标准,比较便携式超声FAST 检查结果符合率。结果 78 例腹部闭合性损伤患者中,3 例因伤情过重抢救无效死亡,45 例开展急诊手术(无手术死亡病例),30 例开展保守治疗。最终诊断结果:单脏器损伤62 例,多脏器损伤16 例;便携式超声FAST 检查结果显示单脏器损伤57 例,符合率为91.94%;多脏器损伤13 例,符合率为81.25%;腹部闭合性损伤诊断符合率为89.74%。结论 便携式超声FAST 检查在诊断急诊腹部闭合性损伤患者中具有诊断符合率高、速度快等优势,携带方便,可为腹部闭合性损伤患者赢得黄金抢救时间,值得应用与推广。

关 键 词:便携式超声  创伤重点超声评估  急诊  腹部闭合性损伤  实质性脏器损伤  空腔脏器损伤

Diagnostic value of portable focused assessment with sonography for trauma scan in emergency patients with closed abdominal injury
Abstract:Objective To explore the diagnostic value of portable focused assessment with sonography for trauma(FAST) scan in emergency patients with closed abdominal injury.Methods Clinical data of 78 patients with closed abdominal injury in the emergency department of Lishui People''s Hospital from June 2018 to January 2020 were retrospectively analyzed.All 78 patients were given Mindray''s M9 portable sonography for abdominal scans.With surgical results or clinical diagnosis as the final standard,the coincidence rate of the results of portable FAST scans was compared.Results Among 78 patients with closed abdominal injury,3 cases died due to excessive injuries and rescue failure.45 cases were given emergency surgery(no deaths from surgery),and 30 cases were given conservative treatment.The final diagnosis results:There were 62 cases of single organ injuries and 16 cases of multiple organ injuries; portable FAST scan results:There were 57 cases of single organ injury,with the coincidence rate of 91.94%; 13 cases of multiple organ injury,with the coincidence rate of 81.25%; the diagnosis coincidence rate of closed abdominal injury was 89.74%.Conclusion The portable FAST scan has the advantages of high diagnostic coincidence rate and fast speed in the diagnosis of patients with closed abdominal injury in emergency department.It is convenient to carry and can win golden rescue time for patients with closed abdominal injury,which is worthy of application and promotion.
Keywords:Portable sonography  Focused assessment with sonography for trauma  Emergency  Closed abdominal injury  Substantial organ damage  Hollow organ damage
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