急诊床边超声对腹部闭合伤肝脾胰损伤临床诊断与治疗中的价值

目的探讨急诊床边超声应用对腹部闭合伤肝脾胰损伤临床诊断与治疗中的价值。方法选取我院2017年9月～2018年8月收治的急诊腹部闭合性损伤患者88例作为研究对象。所有患者均采用床旁超声诊断检查。收集并分析患者肝、脾、胰等实质性脏器情况。仔细辨析声影图像是否有异常影像及腹腔内有无液体等征像。根据患者病情实际情况,积极予以急诊手术或保守治疗处理。结果 82例患者检查结果与诊断结果相符,床边超声临床诊断准确率为93.2%(82/88),漏诊6例(其中肝破损伤2例、脾破损伤1例、胰腺损伤3例)。行手术治疗与保守治疗的患者中,肝破损伤发生率均最高。结论急诊床边超声应用于腹部闭合伤肝脾胰损伤的检查,其检查准确率高,临床应用价值较为广泛,在治疗方面具有十分重要的指导意义。

Value of emergency bedside ultrasound in the diagnosis and treatment of liver,spleen and pancreas injury in abdominal closed injury

Objective To explore the value of emergency bedside ultrasound in the diagnosis and treatment of liver,spleen and pancreas injury in abdominal closed injury.Methods?Eighty-eight patients with emergency abdominal closed injury admitted to our hospital from September 2017 to August 2018 were selected as subjects.All patients were given bedside ultrasound diagnosis.The conditions of liver,spleen,pancreas and other substantial organs were collected and analyzed.Abnormal images and liquid in the abdominal cavity were carefully distinguished.The patients were given emergency surgery or conservative treatment based on their actual situation.Results?The examining results of 82 patients were consistent with the diagnosis.The clinical diagnostic accuracy of bedside ultrasound was 93.2%(82/88),and 6 cases were missed(including 2 cases of liver injury,1 case of spleen injury,and 3 cases of pancreatic injury).Among patients undergoing surgical treatment and conservative treatment,the incidence of liver injury was the highest.Conclusion?In the examination of liver,spleen and pancreas injury in abdominal closure injury,emergency bedside ultrasound has high accuracy,and the clinical application value is extensive.It has important guiding significance in treatment.