Ma O J, Mateer J R, Ogata M, Kefer M P, Wittmann D, Aprahamian C
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee.
J Trauma. 1995 Jun;38(6):879-85. doi: 10.1097/00005373-199506000-00009.
The objective of this prospective study was to determine the sensitivity, specificity, and accuracy of the rapid trauma ultrasound examination, performed by emergency physicians, for detecting free peritoneal and thoracic fluid in patients presenting to a level I trauma center with major blunt or penetrating torso trauma. Emergency medicine residents and faculty were trained to perform an ultrasound examination of the torso evaluating for free intraperitoneal, retroperitoneal, pleural, and pericardial fluid. In the 245 study patients, emergency physicians examined 975 intracavitary spaces and demonstrated 64 positive findings for free fluid as documented by computed tomography scan, diagnostic peritoneal lavage, exploratory laparotomy, chest radiography, tube thoracostomy, or formal two-dimensional echocardiography. The rapid trauma ultrasound examination was 90% sensitive, 99% specific, and 99% accurate. Ultrasonography can serve as an accurate diagnostic adjunct in detecting free peritoneal and thoracic fluid in trauma patients. Appropriately trained emergency physicians can accurately perform and interpret these trauma ultrasound examinations.
这项前瞻性研究的目的是确定由急诊医生进行的快速创伤超声检查对在一级创伤中心就诊的有严重钝性或穿透性躯干创伤患者检测游离腹腔和胸腔积液的敏感性、特异性和准确性。急诊医学住院医师和教员接受了躯干超声检查培训，以评估腹腔内、腹膜后、胸膜和心包游离积液情况。在245例研究患者中，急诊医生检查了975个腔内间隙，发现64例游离积液阳性结果，这些结果经计算机断层扫描、诊断性腹腔灌洗、剖腹探查、胸部X线摄影、胸腔闭式引流或正式二维超声心动图证实。快速创伤超声检查的敏感性为90%，特异性为99%，准确性为99%。超声检查可作为检测创伤患者游离腹腔和胸腔积液的准确诊断辅助手段。经过适当培训的急诊医生能够准确地进行和解读这些创伤超声检查。
