Ollerton J E, Sugrue M, Balogh Z, D'Amours S K, Giles A, Wyllie P
Department of Trauma, Liverpool Hospital, New South Wales, Australia.
J Trauma. 2006 Apr;60(4):785-91. doi: 10.1097/01.ta.0000214583.21492.e8.
Previous studies have concentrated on the accuracy of Focused Assessment with Sonography in Trauma (FAST), but evaluation of whether FAST changes subsequent management has not been fully assessed.
This prospective study compared 419 trauma admissions in two groups, FAST and no-FAST, for demographics, time of resuscitation, and action after resuscitation. The 194 patients undergoing FAST had their management plan specified before, and confirmed after, FAST was performed to assess for change in management. To ensure scan consistency and to minimize bias, criteria were established to define an adequate FAST.
FAST was performed in 194 patients (46%), assessing for free fluid. Management was changed in 59 cases (32.8%) after FAST. Laparotomy was prevented in 1 patient, computed tomography was prevented in 23 patients, and diagnostic peritoneal lavage was prevented in 15 patients. Computed tomography rates were reduced from 47% to 34% and diagnostic peritoneal lavage rates were reduced from 9% to 1%.
FAST plays a key role in trauma, changing subsequent management in an appreciable number of patients.
以往研究主要关注创伤超声重点评估（FAST）的准确性，但FAST是否会改变后续治疗方案尚未得到充分评估。
这项前瞻性研究将419例创伤入院患者分为两组，即FAST组和非FAST组，比较两组患者的人口统计学特征、复苏时间及复苏后的处理措施。对194例行FAST检查的患者，在检查前制定治疗计划，并在检查后确认是否因FAST而改变治疗方案。为确保扫描的一致性并尽量减少偏倚，制定了标准来定义充分的FAST检查。
194例患者（46%）接受了FAST检查以评估有无游离液体。FAST检查后59例（32.8%）患者的治疗方案发生了改变。1例患者避免了剖腹手术，23例患者避免了计算机断层扫描，15例患者避免了诊断性腹腔灌洗。计算机断层扫描率从47%降至34%，诊断性腹腔灌洗率从9%降至1%。
FAST在创伤救治中发挥关键作用，可使相当数量患者的后续治疗方案发生改变。
