Lamke L O, Varenhorst E
Acta Chir Scand. 1978;144(1):21-5.
In a 4 year material of closed abdominal injuries consisting of 114 patients, mostly multiple trauma traffic accidents, diagnostic paracentesis with peritoneal lavage was used in 47 cases. The aim of the investigation was to indicate or exclude blood in the abdominal cavity as early as possible and thereby facilitate the priority of treatment and diminish the delay in surgical intervention. The main indication was suspicion of abdominal injury in multiple traumatized, unconscious or shocked patients. The puncture was performed in the emergency room immediately after ordinary lifesaving steps had been taken. If blood was obtained the patients were sent to the operating theatre for laparotomy. If blood was not obtained one litre of an isotonic salt solution was infused and if the returning solution was only slightly blood tinged, the investigation was continued with roentgenographic methods. In our series only two cases were not correctly diagnosed. Diagnostic paracentesis is the most rapid method of demonstrating intraabdominal bleeding, which is found in 90% of all serious intraabdominal organ injuries. In doubtful cases this method must be combined with other diagnostic methods and the patient put under proper clinical observation.
在一份包含114例患者的4年闭合性腹部损伤资料中，这些患者大多因多发性创伤交通事故受伤，其中47例采用了诊断性腹腔穿刺及腹腔灌洗。本研究的目的是尽早发现或排除腹腔内出血，从而确定治疗的优先级并减少手术干预的延迟。主要指征是怀疑多发创伤、昏迷或休克患者存在腹部损伤。在采取常规的救生措施后，立即在急诊室进行穿刺。如果抽出了血液，患者就被送往手术室进行剖腹手术。如果没有抽出血液，则注入一升等渗盐溶液，若回抽液仅略带血色，则继续采用X线检查方法进行检查。在我们的病例系列中，只有两例诊断错误。诊断性腹腔穿刺是显示腹腔内出血最快速的方法，在所有严重的腹腔内器官损伤中，90%可发现腹腔内出血。在可疑病例中，此方法必须与其他诊断方法相结合，并对患者进行适当的临床观察。
