Nasr-Esfahani Mohammad, Kolahdouzan Mohsen, Shafiei Mehrnoosh
Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2014 Jan;19(1):23-7.
Blunt abdominal trauma is one of the causes of mortality in emergency department. Free fluid in the abdomen due to intra-abdominal blunt trauma can be determined by the surface probe of ultrasound. Since the importance of this free fluid in hemodynamic stable patients with blunt trauma is associated with the unknown outcome for surgeons, this study was performed to evaluate the role of ultrasound surface probe as a screening method in evaluating the patients with blunt abdominal trauma.
A descriptive-analytical study was done on 45 patients with blunt abdominal trauma and hemodynamic stability. The patients were evaluated twice during the three-hours, including repeated ultrasound surface probe and clinical examinations. Computerized tomography was also performed. The patients were divided based on the amount of the free fluid in the abdomen during the evaluations into two groups: Fixed or increased, and decreased free fluid. The results of the different evaluated methods were compared using the sensitivity and specificity.
From 17 patients with CT abnormalities, free fluid increased in 14 patients (82.4%). Free fluid was decreased in three patients who were discharged well from the surgery service without any complication. Surface probe in prognosis detection had a sensitivity of 82.4% and specificity of 92.9%. The percentage of false positive and negative ultrasound compared with CT scan was 7.1% and 17.6%. Also, positive and negative predictive value of the ultrasound with surface probe was 87.5% and 89.7% respectively.
The use of the ultrasound with surface probe in the diagnosis of free fluid in blunt abdominal trauma in hemodynamic stable patients can be considered as a useful screening method.
钝性腹部创伤是急诊科死亡原因之一。腹部钝性创伤导致的腹腔内游离液体可通过超声体表探头检测。鉴于这种游离液体在血流动力学稳定的钝性创伤患者中的重要性与外科医生未知的预后相关，本研究旨在评估超声体表探头作为一种筛查方法在评估钝性腹部创伤患者中的作用。
对45例钝性腹部创伤且血流动力学稳定的患者进行描述性分析研究。在三小时内对患者进行两次评估，包括重复超声体表探头检查和临床检查。还进行了计算机断层扫描。根据评估期间腹腔内游离液体量将患者分为两组：游离液体量固定或增加组，以及游离液体量减少组。使用敏感性和特异性比较不同评估方法的结果。
在17例CT异常的患者中，14例（82.4%）游离液体增加。3例从外科顺利出院且无任何并发症的患者游离液体减少。体表探头在预后检测中的敏感性为82.4%，特异性为92.9%。与CT扫描相比，超声的假阳性和假阴性百分比分别为7.1%和17.6%。此外，超声体表探头的阳性和阴性预测值分别为87.5%和89.7%。
对于血流动力学稳定的钝性腹部创伤患者，使用超声体表探头诊断腹腔内游离液体可被视为一种有用的筛查方法。
