Feliciano D V, Bitondo C G, Steed G, Mattox K L, Burch J M, Jordan G L
Am J Surg. 1984 Dec;148(6):772-7. doi: 10.1016/0002-9610(84)90435-5.
From 1980 to 1984, 500 asymptomatic patients with anterior abdominal stab wounds found to have penetrated the anterior peritoneal cavity on local wound exploration in the emergency center were evaluated by the technique of open peritoneal tap, quantitative diagnostic peritoneal lavage, or both. The technique was found to have several advantages, including earlier diagnosis of intraperitoneal visceral injuries in asymptomatic patients and a significant lowering of the incidence of unnecessary celiotomies in a busy county hospital. Also, it was extremely cost-effective. The major disadvantages were the number of false-positive results of taps and lavages based on red blood cell counts of more than 100,000/mm3, all of which resulted from bleeding from abdominal wall stab wound sites. An accuracy rate of approximately 91 percent was maintained throughout the period of the study, whereas there were only 1.8 false-negative results of lavage per year. Local wound exploration coupled with open peritoneal tap and diagnostic peritoneal lavage is recommended as a rapid, safe, and cost-effective technique for the evaluation of large numbers of asymptomatic patients who present with anterior abdominal stab wounds.
1980年至1984年期间，对500例无症状的腹部刺伤患者进行了评估，这些患者在急诊中心经局部伤口探查发现前腹膜腔已被穿透，评估采用了开放腹膜穿刺术、定量诊断性腹腔灌洗术或两者兼用。结果发现该技术有几个优点，包括能更早诊断无症状患者的腹腔内脏器损伤，以及在一家繁忙的县医院显著降低不必要的剖腹手术发生率。此外，该技术极具成本效益。主要缺点是基于红细胞计数超过100,000/mm³的穿刺和灌洗假阳性结果数量较多，所有这些均源于腹壁刺伤部位的出血。在整个研究期间，准确率维持在约91%，而每年灌洗的假阴性结果仅有1.8例。对于大量出现腹部前刺伤的无症状患者，建议采用局部伤口探查联合开放腹膜穿刺术和诊断性腹腔灌洗术，作为一种快速、安全且具有成本效益的评估技术。
