Dulchavsky S A, Schwarz K L, Kirkpatrick A W, Billica R D, Williams D R, Diebel L N, Campbell M R, Sargysan A E, Hamilton D R
Department of Surgery, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI 48201, USA.
J Trauma. 2001 Feb;50(2):201-5. doi: 10.1097/00005373-200102000-00003.
Thoracic ultrasound may rapidly diagnose pneumothorax when radiographs are unobtainable; the accuracy is not known.
We prospectively evaluated thoracic ultrasound detection of pneumothorax in patients at high suspicion of pneumothorax. The presence of "lung sliding" or "comet tail" artifacts were determined in patients by ultrasound before radiologic verification of pneumothorax by residents instructed in thoracic ultrasound. Results were compared with standard radiography.
There were 382 patients enrolled; the cause of injury was blunt (281 of 382), gunshot wound (22 of 382), stab wound (61 of 382), and spontaneous (18 of 382). Pneumothorax was demonstrated on chest radiograph in 39 patients and confirmed by ultrasound in 37 of 39 patients (95% sensitivity); two pneumothoraces could not be diagnosed because of subcutaneous air; the true-negative rate was 100%.
Thoracic ultrasound reliably diagnoses pneumothorax. Expansion of the focused abdominal sonography for trauma (FAST) examination to include the thorax should be investigated for terrestrial and space medical applications.
当无法获得胸部X光片时，胸部超声检查可快速诊断气胸；但其准确性尚不清楚。
我们前瞻性评估了高度怀疑气胸患者的胸部超声对气胸的检测情况。在接受胸部超声培训的住院医师进行气胸的放射学验证之前，通过超声确定患者是否存在“肺滑动”或“彗尾”伪像。将结果与标准X光片进行比较。
共纳入382例患者；受伤原因包括钝性伤（382例中的281例）、枪伤（382例中的22例）、刺伤（382例中的61例）和自发性气胸（382例中的18例）。39例患者胸部X光片显示气胸，其中37例经超声确诊（敏感性95%）；有两例气胸因皮下气肿而无法诊断；真阴性率为100%。
胸部超声可可靠地诊断气胸。对于陆地和太空医疗应用，应研究将创伤重点腹部超声检查（FAST）扩展至包括胸部检查。
