Mozingo D W, Cioffi W G, McManus W F, Pruitt B A
U.S. Army Institute of Surgical Research, Fort Sam Houston, San Antonio, Texas 78234-5012, USA.
J Trauma. 1995 Jan;38(1):5-7. doi: 10.1097/00005373-199501000-00003.
Intraperitoneal sepsis is difficult to diagnose in thermally injured patients. We reviewed the use of diagnostic peritoneal lavage (DPL) in burn patients suspected of having intraperitoneal infection. Seventeen patients were identified in whom celiotomy, autopsy, or complete recovery could be used to validate the lavage results. A lavage was considered positive if there were greater than 500 white blood cells per mm3 or if microorganisms were present on Gram stain. Six patients had a positive DPL and 11 patients had a negative DPL. There were six true positive, no false positive, ten true negative, and one false negative studies resulting in a sensitivity of 0.86, specificity of 1.00, and diagnostic accuracy of 94%. No complications related to the DPL occurred. This procedure is safe and will rapidly and reliably discriminate between patients needing urgent celiotomy and those requiring further investigation to identify a source of sepsis.
对于热损伤患者，腹膜内脓毒症很难诊断。我们回顾了诊断性腹腔灌洗（DPL）在疑似有腹膜内感染的烧伤患者中的应用情况。确定了17例患者，其开腹手术、尸检或完全康复情况可用于验证灌洗结果。如果每立方毫米白细胞数大于500个，或者革兰氏染色发现微生物，则腹腔灌洗被认为呈阳性。6例患者DPL呈阳性，11例患者DPL呈阴性。有6例假阳性、无假阳性、10例假阴性和1例假阴性研究，敏感性为0.86，特异性为1.00，诊断准确率为94%。未发生与DPL相关的并发症。该操作安全，能快速且可靠地区分需要紧急开腹手术的患者和需要进一步检查以确定脓毒症来源的患者。
