Hubbard S G, Bivins B A, Sachatello C R, Griffen W O
Arch Surg. 1979 Jul;114(7):844-6. doi: 10.1001/archsurg.1979.01370310086015.
Diagnostic peritoneal lavage, considered to be a highly accurate, technique for detecting intraperitoneal blood in the trauma patient, may be less reliable in the presence of a pelvic fracture. In a retrospective review of 222 patients with pelvic fractures, 61 patients were found who had had a diagnostic peritoneal lavage performed as part of the initial evaluation of their condition. Twenty-six of these patients had had a negative lavage result negative lavage result. There had been no false-negative results in this group, although six patients required operations for extraperitoneal injuries. Of the 35 patients with a positive lavage results, 10 (29%) were found to have false-positive lavage results with no intraperitoneal source of bleeding. The only deaths in this series occurred in the group requiring operations, eight of 41 (20%). Four of the eight detahs were due to uncontrollable bleeding that resulted from exploration of the retroperitoneal hematoma. These data suggest that a negative lavage result is highly reliable in the patient with a pelvic fracture and should allow management with confidence that there is no severe intraperitoneal injury. Positive lavage results, however, must be interpreted with caution.
诊断性腹腔灌洗被认为是检测创伤患者腹腔内出血的一种高度准确的技术，但在存在骨盆骨折的情况下可能不太可靠。在一项对222例骨盆骨折患者的回顾性研究中，发现有61例患者在初始病情评估时进行了诊断性腹腔灌洗。其中26例患者灌洗结果为阴性。该组中没有假阴性结果，尽管有6例患者因腹膜外损伤需要手术。在35例灌洗结果为阳性的患者中，有10例（29%）被发现灌洗结果为假阳性，腹腔内并无出血源。该系列中仅有的死亡病例发生在需要手术的组中，41例中有8例（20%）。8例死亡中有4例是由于探查腹膜后血肿导致无法控制的出血。这些数据表明，灌洗结果为阴性在骨盆骨折患者中高度可靠，并且可以放心地进行处理，因为不存在严重的腹腔内损伤。然而，灌洗结果为阳性时必须谨慎解读。
