Boulanger B R, Brenneman F D, McLellan B A, Rizoli S B, Culhane J, Hamilton P
Department of Surgery, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
J Trauma. 1995 Aug;39(2):325-30. doi: 10.1097/00005373-199508000-00022.
In North America, the role of emergent abdominal sonography [ultrasonography (US)] after blunt trauma requires further definition. The purpose of this prospective study was to compare US to the gold standards, diagnostic peritoneal lavage (DPL), and computed tomography (CT), in a population of adults after blunt trauma. In 206 adults who required either CT or DPL to assess possible abdominal injury, US was performed, before DPL or CT, and was aimed at the detection of intraperitoneal fluid. The mean Injury Severity Score and Glasgow Coma Scale score were 24.0 and 11.9, respectively. One hundred thirty-seven patients (67%) had CT and 69 (33%) had DPL. The positive and negative predictive values of US for intraperitoneal fluid were 90% and 97%, respectively. The sensitivity, specificity, and accuracy of US for free fluid were 81%, 98%, and 96%, respectively. Of the six false-negative USs, only one required surgery. The US examinations required 2.6 +/- 1.4 min. Emergent abdominal sonography is an accurate, rapid test for the presence of intraperitoneal fluid in adult blunt trauma victims and in these patients may prove valuable as a screening test for abdominal injury.
在北美，钝性创伤后急诊腹部超声检查[超声检查（US）]的作用需要进一步明确。这项前瞻性研究的目的是在钝性创伤后的成年人群中，将超声检查与金标准诊断性腹腔灌洗（DPL）和计算机断层扫描（CT）进行比较。在206例需要进行CT或DPL以评估可能的腹部损伤的成年人中，在进行DPL或CT之前先进行了超声检查，目的是检测腹腔内液体。平均损伤严重度评分和格拉斯哥昏迷量表评分分别为24.0和11.9。137例患者（67%）进行了CT检查，69例（33%）进行了DPL检查。超声检查对腹腔内液体的阳性和阴性预测值分别为90%和97%。超声检查对游离液体的敏感性、特异性和准确性分别为81%、98%和96%。在6例假阴性超声检查中，只有1例需要手术。超声检查需要2.6±1.4分钟。急诊腹部超声检查是一种准确、快速的检测成年钝性创伤患者腹腔内液体的方法，在这些患者中，它可能作为腹部损伤的筛查试验具有重要价值。
