全身计算机断层扫描在严重创伤患者中的应用。

Whole-body computed tomography in severely injured patients.

机构信息

Department of Trauma Surgery.

Department of Experimental Trauma Surgery, Klinikum rechts der Isar, Technical University Munich - TUM, Munich.

出版信息

Curr Opin Crit Care. 2018 Feb;24(1):55-61. doi: 10.1097/MCC.0000000000000474.

Abstract

PURPOSE OF REVIEW

To provide an update on the relevant and recent studies on whole-body computed tomography (WBCT) imaging of severely injured patients.

RECENT FINDINGS

The advantages of WBCT in time saving, diagnostic accuracy and even in survival have been proven in numerous studies. WBCT can also be beneficial in haemodynamically unstable major trauma patients. The CT scanner should be located close to the emergency department or even in the trauma room. The issue of radiation is still quite important, however, iterative as well as split-bolus protocols can nowadays reduce radiation significantly. The question: which trauma patient should receive WBCT and which not is not yet solved sufficiently. Postmortem WBCT has a promising potential to promptly define the definitive cause of death of trauma victims comparably to traditional autopsy.

SUMMARY

On account of the recent advances, whole-body CT has become a crucial part of the initial in-hospital assessment of severely injured patients. It is recommended as the standard radiological tool for the emergency diagnostic work-up in major trauma patients.

摘要

目的综述

提供关于严重创伤患者全身计算机断层扫描(WBCT)影像学的相关最新研究进展。

最近的发现

大量研究已经证明,WBCT 在节省时间、提高诊断准确性甚至提高生存率方面具有优势。WBCT 对血流动力学不稳定的严重创伤患者也可能有益。CT 扫描仪应靠近急诊室,甚至在创伤室中。然而,辐射问题仍然非常重要,但是现在迭代和分段式注射方案可以大大降低辐射。目前还没有充分解决“哪些创伤患者应该接受 WBCT,哪些不应该接受”的问题。与传统尸检相比,死后 WBCT 具有快速明确创伤受害者死亡原因的巨大潜力。

总结

鉴于最近的进展,全身 CT 已成为严重创伤患者院内初步评估的关键部分。建议将其作为严重创伤患者急诊诊断的标准影像学工具。

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