Karki O B
Department of Surgery, Manipal College of Medical Sciences, Pokhara, Nepal.
JNMA J Nepal Med Assoc. 2015 Oct-Dec;53(200):227-230.
Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma.
A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Organ injuries were graded using the Organ Injury Scale guidelines.
Most of the patients in our study were in the age group of 21-40 years with an M: F ratio of 2.3:1. Road traffic accident (47.5%) was the most common mechanism of injury. Spleen (27.5%) was the commonest organ injured. CT scan was superior to FAST scan and had sensitivity of 97.3% specificity 75% positive predictive value 98.6%. FAST scan had sensitivity of 78.9%, specificity 50%, positive predictive value 96% with p- value of 0.0034. 81% of patients were conservatively managed.
In conjunction with close clinical monitoring, CT scan is reliable in the evaluation and management of blunt abdominal trauma patients. Our study also shows CT as a superior diagnostic modality compared to FAST scan.
钝性创伤在急诊科经常遇到。有助于钝性腹部创伤最佳管理的诊断工具包括；创伤重点超声检查、诊断性腹腔灌洗和计算机断层扫描。本研究的目的是确定CT扫描作为一种准确诊断工具的有效性及其在钝性腹部创伤患者管理中的作用。
对在尼泊尔博卡拉马尼帕尔教学医院15个月内收治的80例钝性腹部创伤患者进行前瞻性分析。研究了人口统计学数据、创伤机制、管理和结果。使用器官损伤量表指南对器官损伤进行分级。
我们研究中的大多数患者年龄在21-40岁之间，男女比例为2.3:1。道路交通事故（47.5%）是最常见的损伤机制。脾脏（27.5%）是最常受伤的器官。CT扫描优于快速超声检查，敏感性为97.3%，特异性为75%，阳性预测值为98.6%。快速超声检查的敏感性为78.9%，特异性为50%，阳性预测值为96%，p值为0.0034。81%的患者接受了保守治疗。
结合密切的临床监测，CT扫描在钝性腹部创伤患者的评估和管理中是可靠的。我们的研究还表明，与快速超声检查相比，CT是一种更优越的诊断方式。
