Feliciano D V
Department of Surgery, University of Rochester Medical Center, New York.
Surg Clin North Am. 1991 Apr;71(2):241-56. doi: 10.1016/s0039-6109(16)45377-6.
Numerous algorithms encompassing the diagnostic studies described above have been published in recent years. For practical purposes, diagnostic peritoneal lavage and CT scanning are the diagnostic studies most commonly used in patients without obvious indications for celiotomy after blunt or penetrating abdominal trauma. Diagnostic peritoneal lavage is invasive, rapidly performed, cheap, and accurate and has a primary role in documenting intra-abdominal bleeding or contamination in hypotensive patients with blunt trauma or selected stable patients with penetrating stab wounds. It misses small and large injuries to the diaphragm and cannot rule out injury to retroperitoneal structures. Computed tomography is noninvasive, time consuming to perform, expensive, and accurate and has a primary role in defining the location and magnitude of intra-abdominal injuries in stable patients with blunt trauma or with penetrating trauma to the flank or back. In many hospitals, it misses gastrointestinal perforations or ruptures. Both studies may be needed in the same stable patient, and both should be available and used in a complementary fashion in the modern trauma center.
近年来已发表了许多包含上述诊断性检查的算法。出于实际目的，诊断性腹腔灌洗和CT扫描是钝性或穿透性腹部创伤后无明显剖腹手术指征患者最常用的诊断性检查。诊断性腹腔灌洗具有侵入性，操作迅速、成本低且准确，在记录钝性创伤导致的低血压患者或部分穿透性刺伤稳定患者的腹腔内出血或污染方面具有主要作用。它会漏诊膈肌的大小损伤，也无法排除腹膜后结构损伤。计算机断层扫描是非侵入性的，操作耗时、成本高且准确，在确定钝性创伤稳定患者或 flank 或背部穿透性创伤患者腹腔内损伤的位置和程度方面具有主要作用。在许多医院，它会漏诊胃肠道穿孔或破裂。在同一位稳定患者中可能需要这两项检查，并且在现代创伤中心这两项检查都应具备并以互补方式使用。 （注：原文中“flank”可能是“腹部侧面”之意，这里直接保留英文未翻译，因为不确定准确中文术语是否就是“腹部侧面”，也可能是特定医学术语中的特定部位表述）
