Waydhas C, Nast-Kolb D, Blahs U, Pfeifer K J, Schweiberer L
Chirurgische Klinik und Chirurgische Poliklinik, Klinikum Innenstadt der Universität München.
Chirurg. 1991 Nov;62(11):789-92; discussion 792-3.
Diagnostic peritoneal lavage (DPL) and abdominal sonography (AS) were prospectively evaluated in emergency room diagnostics of blunt abdominal trauma in 106 multiple injured patients (ISS 40 pts). The incidence of intraabdominal lesions was 38.7%. 82 DPL and 64 AS were performed. In 45 patients both procedures were done, in 19 patients only AS and in 37 patients only DPL. The over-all accuracy of DPL and AS was 95% and 88%, respectively. Sensitivity was 91 vs. 74%, specificity 98 vs. 95%. The combined use of both procedures increased accuracy to 98%. We conclude that AS is the initial screening method for the detection of intraabdominal lesions in multiple injured patients. In any case of negative AS and hemodynamic instability or ambiguous AS, DPL should be performed immediately to improve diagnostic accuracy without delaying treatment.
对106例多发伤患者（损伤严重度评分40分）进行了诊断性腹腔灌洗（DPL）和腹部超声检查（AS），以评估其在钝性腹部创伤急诊诊断中的应用。腹腔内损伤的发生率为38.7%。共进行了82次DPL和64次AS检查。45例患者同时接受了这两种检查，19例患者仅接受了AS检查，37例患者仅接受了DPL检查。DPL和AS的总体准确率分别为95%和88%。敏感性分别为91%和74%，特异性分别为98%和95%。两种检查方法联合使用可将准确率提高到98%。我们得出结论，AS是检测多发伤患者腹腔内损伤的初始筛查方法。在AS检查结果为阴性且存在血流动力学不稳定或AS检查结果不明确的任何情况下，应立即进行DPL检查，以提高诊断准确率，同时不延误治疗。
