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腹部游离液体的超声检测:急诊住院医师与放射科住院医师的比较

Sonographic Detection of Abdominal Free Fluid: Emergency Residents vs Radiology Residents.

作者信息

Shojaee Majid, Faridaalaee Gholamreza, Sabzghabaei Anita, Safari Saeed, Mansoorifar Hamid, Arhamidolatabadi Ali, Keyghobadi Fatemeh

机构信息

Emergency Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

Emergency Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran ; Emergency Medicine Department, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

出版信息

Trauma Mon. 2013 Winter;17(4):377-9. doi: 10.5812/traumamon.5476. Epub 2013 Jan 15.

Abstract

BACKGROUND

Focused assessment with sonography for trauma (FAST) has become a part of initial examinations in trauma care at emergency departments (ED).

OBJECTIVES

The goal of the present study was to evaluate the accuracy of FASTs performed by emergency residents (ER) in detection of abdominal free fluid following blunt trauma.

MATERIALS AND METHODS

In this study, the reports of ERs performing FASTs on 286 admitted patients following blunt trauma were compared with those of radiology residents (RR) in relation to presence of abdominal free fluid. In addition, the reports of the two resident groups were compared with the final abdominal outcome, based on the results of abdominal computed tomography (CT) and clinical follow up.

RESULTS

The ERs had reported abdominal free fluid in 20 (6.9%) patients while RRs performing FAST had positive results in 22 (7.6%) patients. The reports of FASTs revealed significant correlation between the two resident groups (P < 0.001). ERs performing FASTs had 90% sensitivity and 98.5% specificity in comparison to RRs sonography reports. Furthermore, ER-performed FASTs had 96.5% accuracy in relation to final outcome.

CONCLUSIONS

Following training, ED residents can perform FAST with high accuracy and specificity, similar to RR residents, in patients with blunt abdominal trauma.

摘要

背景

创伤重点超声评估(FAST)已成为急诊科创伤护理初始检查的一部分。

目的

本研究的目的是评估急诊住院医师(ER)进行的FAST在检测钝性创伤后腹腔游离液体方面的准确性。

材料与方法

在本研究中,将286例钝性创伤后住院患者接受ER进行FAST的报告与放射科住院医师(RR)关于腹腔游离液体存在情况的报告进行比较。此外,根据腹部计算机断层扫描(CT)结果和临床随访,将两组住院医师的报告与最终腹部结果进行比较。

结果

ER报告20例(6.9%)患者存在腹腔游离液体,而进行FAST的RR报告22例(7.6%)患者结果为阳性。FAST报告显示两组住院医师之间存在显著相关性(P < 0.001)。与RR的超声报告相比,ER进行的FAST敏感性为90%,特异性为98.5%。此外,ER进行的FAST与最终结果的准确性为96.5%。

结论

经过培训后,急诊科住院医师在钝性腹部创伤患者中进行FAST时,能够达到与RR住院医师相似的高精度和特异性。

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