Blankstein A, Cohen I, Heiman Z, Salai M, Heim M, Chechick A
Department of Orthopedic Surgery and Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
Arch Orthop Trauma Surg. 2000;120(9):514-7. doi: 10.1007/s004020000173.
Penetrating wounds and lacerations are frequent pathologies treated in the emergency room. The management of hand trauma represents a large part of the work in any surgical practice. Although X-rays are routinely taken, numerous foreign bodies remain undetected, and the wounds are just locally debrided and the lacerations sutured. Unfortunately, as not all foreign bodies are radio-opaque, the radiography results may appear normal, but the patient fails to recover. Patients complaining of persistent wound tenderness were sent for ultrasound investigations, and foreign bodies were detected. Had ultrasonography been carried out initially in the emergency room, the correct diagnosis would have been made, and the sonographic equipment could have helped to guide the physician in his attempt to remove the foreign body. Usually, in response to continued pain, an ultrasound investigation is ordered, and the pathology becomes apparent. A number of examples are briefly described in order to highlight the present inadequacies. It is suggested that hospital administrators consider the need to provide ultrasonographic services as an integral facility of the emergency room.
穿透伤和撕裂伤是急诊室常见的治疗病症。手部创伤的处理在任何外科手术实践中都占很大一部分工作。尽管常规会进行X光检查，但仍有许多异物未被发现，伤口仅进行局部清创，撕裂伤则进行缝合。不幸的是，由于并非所有异物都是不透射线的，X光检查结果可能看似正常，但患者却无法康复。主诉伤口持续压痛的患者被送去做超声检查，结果发现了异物。如果在急诊室最初就进行超声检查，就能做出正确诊断，而且超声设备本可帮助医生在尝试取出异物时提供指导。通常，由于持续疼痛，会安排超声检查，病理情况才会显现出来。简要描述了一些例子以突出当前存在的不足。建议医院管理人员考虑将提供超声检查服务作为急诊室不可或缺的设施。
