扩展创伤重点超声评估技术在腹部闭合性创伤患者检查中的应用研究

目的探讨扩展创伤重点超声评估技术(EFAST)在腹部闭合性创伤患者检查中的应用价值。方法回顾性分析2017年2月至2018年2月医院腹部闭合性创伤患者156例病历及影像资料,所有患者均行EFAST、CT检查。以手术结果为金标准,比较EFAST、CT、EFAST+CT三种方法诊断效能、检查时间及费用。结果156例患者中,共计检查780个结果。手术结果显示216例脏器损伤脾损伤86例,肝损伤37例,肾脏损伤53例,腹膜血肿22例,胰腺损伤18例。EFAST检出阳性164例,阴性546例;CT检出阳性185例,阴性554例;EFAST+CT检出阳性200例,阴性560例。CT检测灵敏度、准确度高于EFAST;EFAST+CT灵敏度、特异度、准确度、阳性预测值、阴性预测值高于EFAST,灵敏度、准确度、阴性预测值高于CT,差异均有统计学意义(P<0.05)。FAST检查时间短于CT,检查费用低于CT,差异均有统计学意义(P<0.01)。结论EFAST较CT而言,具有检查时间短、费用低、诊断效能较高的特点,可用于腹部闭合性创伤患者早期检查,联合CT检查能提高腹部闭合性创伤的诊断效能。

Application of extended focused assessment with sonography for trauma in patients with blunt abdominal trauma

Objective To investigate the application value of extended focused assessment with sonography for trauma(EFAST)in patients with blunt abdominal trauma.Methods Medical records and imaging data of 156 patients with abdominal closed trauma from February 2017 to February 2018 were analyzed retrospectively.All patients received EFAST and CT examinations.The surgical results were used as the“gold standard”.The diagnostic efficacy,examination time and cost were compared between EFAST,CT and EFAST+CT.Results In the 156 patients,total 780 results were obtained.Surgical results showed that there were 216 cases with organ injury,86 with spleen injury,37 with liver injury,53 with kidney injury,22 with peritoneal hematoma,and 18 with pancreatic injury.EFAST showed 164 positive cases and 546 negative cases.CT showed 185 positive cases and 554 negative cases.EFAST+CT showed 200 positive cases and 560 negative cases.The sensitivity and accuracy of CT were higher than those of EFAST(P<0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of EFAST+CT were higher than EFAST(P<0.05)and the sensitivity,accuracy,and negative predictive value were higher than CT(P<0.05).Conclusion EFAST has the characteristics of short inspection time and low cost when compared to CT.It can be used in the early examination of patients with blunt abdominal trauma.Combination of CT examination can improve the diagnostic efficiency of the patients with blunt abdominal trauma.