腹部创伤定点超声检查对急诊腹部闭合性创伤的临床诊断价值

目的]探讨腹部创伤定点超声检查(FAST)对急诊腹部闭合性创伤的临床诊断价值.方法]选择2015年6月至2016年8月经本院急诊科收治的200例腹部闭合性创伤患者的临床资料,所有患者先行FAST检查,待生命体征平稳后,再前往CT室行腹部CT检查.将两种诊断结果与临床实际手术结果进行对比,分析两种检查方法的诊断时间及检出率.结果]FAST检查结果在肝破裂、肾损伤、脾破裂、腹膜出血检查符合率为86.49%、88.24%、85.92%、73.91%,FAST+CT联合检查符合率为97.30%、97.10%、97.10%、95.65%,FAST检查符合率与FAST+CT联合检查相比,在肾损伤及腹膜出血方面的诊断检查符合率差异具有统计学意义(P<0.05).FAST诊断所用时间为(4.12±0.85)min明显短于CT诊断(26.13±1.27)min,差异有统计学意义(P<0.05);FAST检查对腹部损伤诊断的检出率为85.00%(170/200),漏诊率为0,FAST+CT联合检查对腹部损伤诊断的检出率为96.00%(192/200),漏诊率为0,两种检查方法的检出率比较差异具有统计学意义(χ2=14.0739,P=0.0002<0.05).结论]FAST超声检查其作为急诊科常见检查设备,诊断具有用时较短,且检出率高的优点,操作简单便于使用,在其基础上联合CT检查,可以进一步提高腹部创伤的检出情况,临床应用价值较高.

Clinical Diagnostic Value of Focussed Assessment Sonograph in Emergency Abdominal Closed Trauma

Objective] To investigate the clinical diagnosis of emergency abdominal closed trauma measured by focussed assessment sonograph trauma (FAST).Methods]The clinical data of 200 patients with abdominal closed trauma were selected from June 2015 to August 2016.All patients had FAST first, then went to the CT room for abdominal CT examination after vital signs were stable.The diagnostic results and the detection rate of the two methods (FAST and CT) were compared.Results]The detection rate of FAST test for liver rupture, renal injury,s plenic rupture, peritoneal, and hemorrhage was 86.49%, 88.24%, 85.92% and 73.91%, respectively.the detection rate of FAST + CT was 97.30%, 97.10% and 97.10%, and 95.65%, respectively.Renal injury and peritoneal hemorrhage diagnostic rates between FAST and FAST+CT were statistically significant (P<0.05).FAST exam time period (4.12±0.85)min was significantly shorter than that of CT (26.13 ± 1.27) min;the difference was statistically significant (P<0.05).The positive detection rate of FAST examination for abdominal injury was 85.00% (170 /200,P<0.05) and the missed rate was 0%.The positive detection rate of FAST+CT was 96.00% (192/200) and the rate of missed diagnosis was 0%.The difference between the two methods was statistically significant(χ2=14.0739,P=0.0002<0.05).Conclusion] FAST ultrasound examination as a common inspection equipment has advantage of having a simple procedure, being easy to use, and able to complete the diagnosis in a shorter time with a high detection rate for emergency abdominal closed trauma.In combination with CT examination, it can further improve the diagnosis with higher clinical application value.