腹部超声检查在钝性腹部创伤患者中的诊断价值。

Diagnostic value of abdominal ultrasonography in patients with blunt abdominal trauma.

作者信息

Nnamonu Michael I, Ihezue Chikwem H, Sule Augustine Z, Ramyil Venyir M, Pam Stephen D

机构信息

Department of Surgery, University of Jos, Jos, Nigeria.

Department of Radiology, University of Jos, Jos, Nigeria.

出版信息

Niger J Surg. 2013 Jul;19(2):73-8. doi: 10.4103/1117-6806.119243.

DOI:10.4103/1117-6806.119243

PMID:24497755

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3899552/

Abstract

BACKGROUND

Various investigative modalities are used to detect intra-abdominal injury requiring surgical intervention. Ultrasonography (US) is a cheap, readily available, safe and non-invasive investigation used in the evaluation of patients with blunt abdominal trauma. Patients are subjected to no added risk of radiation.

AIMS

The aim of this study was to evaluate the diagnostic value of US in patients with blunt abdominal trauma.

MATERIALS AND METHODS

Patients who had US for blunt abdominal trauma were prospectively evaluated from 1 January 2006 to 31 December 2007. A total of 57 patients were included is this study. US results in each patient were classified as true positive (TP), false positive (FP), false negative (FN) or true negative (TN) by comparing with findings at either diagnostic peritoneal lavage or surgery. Sensitivity, specificity, positive and negative predictive values (NPV) and diagnostic accuracy of US in detecting free fluid and in detecting the visceral parenchymal injury were calculated using two by two tables. The Epi Info statistical software version 3.4.1 was used for data analysis.

RESULTS

By scanning to detect free fluid, TPs were 46, FPs three, FNs two and TNs six. Sensitivity, specificity, positive and NPV and the diagnostic accuracy were 96%, 67%, 94%, 75% and 91% respectively. By scanning to detect the parenchymal injury, TPs were 24, FPs 15, FNs 10 and TNs 8. Sensitivity, specificity, positive and NPV and diagnostic accuracy were 71%, 35%, 62%, 44% and 56% respectively.

CONCLUSION

US has a high diagnostic value in the screening of patients with blunt abdominal trauma. Scanning for the presence of free fluid yields better results than scanning for the visceral parenchymal injury.

摘要

背景

多种检查方式用于检测需要手术干预的腹腔内损伤。超声检查（US）是一种廉价、易于获得、安全且无创的检查方法，用于评估钝性腹部创伤患者。患者无需承担额外的辐射风险。

目的

本研究旨在评估超声检查在钝性腹部创伤患者中的诊断价值。

材料与方法

对2006年1月1日至2007年12月31日期间因钝性腹部创伤接受超声检查的患者进行前瞻性评估。本研究共纳入57例患者。通过与诊断性腹腔灌洗或手术结果进行比较，将每位患者的超声检查结果分为真阳性（TP）、假阳性（FP）、假阴性（FN）或真阴性（TN）。使用四格表计算超声检查在检测游离液体和检测内脏实质损伤方面的敏感性、特异性、阳性和阴性预测值（NPV）以及诊断准确性。使用Epi Info统计软件3.4.1版进行数据分析。

结果

通过扫描检测游离液体，TP为46例，FP为3例，FN为2例，TN为6例。敏感性、特异性、阳性和NPV以及诊断准确性分别为96%、67%、94%、75%和91%。通过扫描检测实质损伤，TP为24例，FP为15例，FN为10例，TN为8例。敏感性、特异性、阳性和NPV以及诊断准确性分别为71%、35%、62%、44%和56%。