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多发伤的影像学检查——原则与当前概念

Imaging in polytrauma - Principles and current concepts.

作者信息

Thippeswamy Pushpa Bhari, Rajasekaran Raja Bhaskara

机构信息

Department of Radiology, Ganga Medical Centre & Hospitals Pvt. Ltd, 313, Mettupalayam Road, Coimbatore, India.

Dept. of Orthopaedics, Ganga Medical Centre & Hospitals Pvt. Ltd, Coimbatore, India.

出版信息

J Clin Orthop Trauma. 2020 Dec 5;16:106-113. doi: 10.1016/j.jcot.2020.12.006. eCollection 2021 May.

Abstract

Imaging forms a crucial component in reducing mortality of polytraumatized patients by aiding appropriate diagnosis and guiding the emergency and definitive treatment. With the exponential expansion in the radiological armamentarium and introduction of protocols like Extended focused assessment with sonography for trauma (EFAST) and Whole body Computed tomography (WBCT), the role of imaging has considerably increased. Emergency imaging protocols should be done for rapid diagnosis of life-threatening injuries allowing simultaneous evaluation and resuscitation. Subsequent comprehensive imaging is essential to diagnose the often clinically missed injuries to reduce the overall morbidity. Imaging protocols must adapt to the patient's clinical scenario, which can be dynamically changing. Each trauma team should devise clear guidelines, protocols, and algorithms suitable for their center depending on the local availability of types of equipment and expertise. Radiologists must efficiently communicate and adopt patient-centered approach to ensure early appropriate care to these severely injured patients. Future research should involve multicentre studies to formulate the most appropriate imaging protocol in polytrauma to increase diagnostic accuracy and thereby reduce patient mortality.

摘要

影像学通过辅助恰当诊断以及指导急诊和确定性治疗,在降低多发伤患者死亡率方面发挥着关键作用。随着放射学检查手段呈指数级扩展,以及诸如创伤超声重点评估(EFAST)和全身计算机断层扫描(WBCT)等方案的引入,影像学的作用已大幅提升。急诊影像学检查方案应进行,以便快速诊断危及生命的损伤,实现同步评估和复苏。后续的全面影像学检查对于诊断常常在临床上被漏诊的损伤至关重要,以降低总体发病率。影像学检查方案必须适应患者动态变化的临床情况。每个创伤团队应根据当地设备类型和专业知识的可获得情况,制定适合其中心的明确指南、方案和算法。放射科医生必须有效地沟通并采用以患者为中心的方法,以确保对这些重伤患者尽早给予恰当治疗。未来的研究应包括多中心研究,以制定多发伤中最合适的影像学检查方案,提高诊断准确性,从而降低患者死亡率。

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