Lindelius A, Törngren S, Pettersson H, Adami J
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Surgery, Stockholm South General Hospital, Sjukhusbacken 10, 118 83 Stockholm, Sweden.
Emerg Med J. 2009 Aug;26(8):561-6. doi: 10.1136/emj.2008.062067.
The use of bedside ultrasound performed by the surgeon or emergency physician on duty at the emergency department is increasing. A study was performed which is the first randomised study to evaluate the benefits of surgeon-performed ultrasound for the management of the acute abdomen.
800 patients who attended the emergency department at Stockholm South General Hospital, Sweden for abdominal pain were randomised either to receive or not receive surgeon-performed ultrasound as a complement to routine management. Outcome measures included the number of complementary investigations, time spent in the emergency department, admission rate, length of hospital stay if admitted, admission to surgery and timing of surgery if required.
The number of complementary ultrasound examinations was considerably higher in the group who did not receive bedside ultrasound (18.8 percentage points difference, p<0.001). The admission rate was lower in the ultrasound group (7.2 percentage points difference, p = 0.041) and the proportion of patients requiring surgery submitted for surgery directly from the emergency department was higher in the ultrasound group (18.5 percentage points difference, p = 0.013).
This study shows benefits in the management of the acute abdomen resulting in fewer further requested examinations, fewer admissions and shorter lead times to surgery. On the basis of these results, it is recommended for implementation in emergency departments.
NCT00550511.
由外科医生或急诊科值班急诊医师进行的床旁超声检查的应用正在增加。开展了一项研究，这是第一项评估外科医生进行超声检查对急腹症处理益处的随机研究。
800名因腹痛前往瑞典斯德哥尔摩南部综合医院急诊科就诊的患者被随机分组，一组接受外科医生进行的超声检查作为常规处理的补充，另一组不接受。观察指标包括补充检查的次数、在急诊科停留的时间、入院率、若入院后的住院时间、手术入院情况以及若需要手术的手术时机。
未接受床旁超声检查的组中补充超声检查的次数显著更高（相差18.8个百分点，p<0.001）。超声检查组的入院率较低（相差7.2个百分点，p = 0.041），且超声检查组中直接从急诊科送去手术的需要手术患者的比例更高（相差18.5个百分点，p = 0.013）。
本研究表明在急腹症处理方面存在益处，可减少进一步检查的需求、减少入院人数并缩短至手术的准备时间。基于这些结果，建议在急诊科实施。
NCT00550511。
