Department of Hepato-Biliary-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
J Trauma Acute Care Surg. 2012 Oct;73(4):890-4. doi: 10.1097/TA.0b013e318256dfe1.
Abdominal injuries constitute a small proportion of all earthquake-related traumas; however, it often resulted in fatal hemorrhage. Ultrasonography has been described as an effective triage tool in the evaluation of blunt abdominal trauma. We aimed to present an overview of the diagnostic accuracy of screening ultrasonography for patients with blunt abdominal trauma admitted to various hospitals during the Wenchuan earthquake in China.
We retrospectively analyzed the patients with blunt abdominal trauma who underwent ultrasonography after admission to various hospitals. Ultrasonography findings were considered positive if evidence of free fluid or a parenchymal injury was identified. Ultrasonography findings were compared with the findings of computed tomography, diagnostic peritoneal lavage, repeated ultrasonography, cystography, operation, and/or the clinical course.
Findings from 2,204 ultrasonographic examinations were evaluated. Findings of 199 ultrasonographic examinations (9.0%) were considered positive. Of the patients, 12 (0.5%) had a false-negative ultrasonographic findings; of this group, 3 (25%) required exploratory laparotomy. Ultrasonography had a sensitivity of 91.9%, specificity of 96.9%, and an accuracy of 96.6% for detection of abdominal injuries. Positive predictive value was 68.3%, and negative predictive value was 99.4%.
Screening ultrasonography is highly reliable in the setting of blunt abdominal trauma after earthquake. It should be used as an initial diagnostic modality in the evaluation of most blunt abdominal trauma.
Diagnostic study, level III.
腹部损伤在所有与地震相关的创伤中所占比例较小，但往往导致致命性出血。超声检查已被描述为评估钝性腹部创伤的有效分诊工具。我们旨在介绍中国汶川地震期间各医院收治的钝性腹部创伤患者的超声筛查诊断准确性概述。
我们回顾性分析了各医院收治的钝性腹部创伤患者。如果发现游离液体或实质损伤，则认为超声检查结果阳性。将超声检查结果与计算机断层扫描、诊断性腹腔灌洗、重复超声检查、膀胱造影、手术和/或临床过程进行比较。
共评估了 2204 次超声检查的结果。199 次超声检查（9.0%）结果阳性。在这些患者中，有 12 例（0.5%）超声检查结果为假阴性；其中 3 例（25%）需要剖腹探查。超声检查对腹部损伤的敏感性为 91.9%，特异性为 96.9%，准确性为 96.6%。阳性预测值为 68.3%，阴性预测值为 99.4%。
地震后，超声筛查在钝性腹部创伤中具有高度可靠性。它应作为评估大多数钝性腹部创伤的初始诊断方法。
诊断研究，III 级。
