Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Copenhagen, Denmark.
Eur J Emerg Med. 2010 Oct;17(5):249-53. doi: 10.1097/MEJ.0b013e328336adce.
Ultrasound (US) has been used for in-hospital evaluation of the trauma victim for many years. The outcome in severely injured patients remains heavily influenced by initial life support and early care, as time plays a major role. Development of handheld, battery-powered, low-weight US machines has created the possibility of bringing US to the prehospital setting, thus gaining a potential for early diagnosis and treatment. The objective of this study was to systematically search the literature for evidence that prehospital US of the abdomen or thorax increases survival of trauma patients. The data regarding the use of US in the prehospital setting is sparse, often of low quality and describing a broad variety of patients and clinical challenges. Therefore, from an evidence point of view it is not possible to answer the objectives in this review. In the prehospital setting, rapid assessment plays an important role, as initial life support and early surgical care influences the outcome of the severely injured patient. Time is especially crucial in blunt abdominal trauma and penetrating truncal injuries. Several studies in this review showed that prehospital US is feasible and that the procedure is highly reliable in detection of haemoperitoneum or haemopericardium compared with the low accuracy of physical examination and haemodynamic measurements. An early diagnosis will provide the prehospital physician with the knowledge to prioritize the relevant initial treatment and to choose the closest appropriate hospital and transportation form. There is currently no evidence in the literature that prehospital US of the abdomen or thorax improves treatment of trauma patients.
超声（US）在医院内用于创伤患者评估已有多年。严重受伤患者的结局仍然受到初始生命支持和早期护理的严重影响，因为时间起着主要作用。手持式、电池供电、重量轻的 US 机的发展为将 US 带到院前环境创造了可能性，从而为早期诊断和治疗提供了潜在可能性。本研究的目的是系统地搜索文献，以寻找证据证明院前腹部或胸部 US 可提高创伤患者的生存率。关于 US 在院前环境中的使用的数据很少，通常质量较低，描述了广泛的患者和临床挑战。因此，从证据角度来看，无法回答本综述中的目标。在院前环境中，快速评估起着重要作用，因为初始生命支持和早期手术护理会影响严重受伤患者的结局。时间在钝性腹部创伤和穿透性躯干损伤中尤为关键。本综述中的几项研究表明，与体格检查和血流动力学测量的低准确性相比，院前 US 检测血腹或血胸是可行的，且该程序在检测血腹或血胸方面高度可靠。早期诊断将使院前医生了解如何优先进行相关的初始治疗，并选择最近的合适医院和运输方式。目前，文献中尚无证据表明院前腹部或胸部 US 可改善创伤患者的治疗效果。
