Sweeney J F, Albrink M H, Bischof E, McAllister E W, Rosemurgy A S
Department of Surgery, University of South Florida, Tampa.
Injury. 1994 Dec;25(10):659-61. doi: 10.1016/0020-1383(94)90008-6.
While the ability of diagnostic peritoneal lavage (DPL) to 'rule out' occult intra-abdominal injuries has been well established, the volume of lavage effluent necessary for accurate prediction of a negative lavage has not been determined. To address this, 60 injured adults with blunt (N = 45) or penetrating (N = 15) trauma undergoing DPL were evaluated prospectively through protocol. After infusion of 1l of Ringer's lactate solution, samples of lavage effluent were obtained at 100 cm3, 250 cm3, 500 cm3, and 759 cm3, and when no more effluent could be returned (final sample). DPL was considered negative if final sample RBC count was < or = 100,000/mm3 for blunt injury and < 50,000/mm3 for penetrating injury. The conclusion is that at 100 cm3 of lavage effluent returned, negative results are highly predictive of a negative DPL (98 per cent), though 250 cm3 of lavage effluent is required to predict a negative DPL uniformly (100 per cent).
虽然诊断性腹腔灌洗（DPL）“排除”隐匿性腹腔内损伤的能力已得到充分证实，但准确预测灌洗阴性所需的灌洗流出液量尚未确定。为解决这一问题，对60例接受DPL的钝性伤（N = 45）或穿透伤（N = 15）成年伤者进行了前瞻性方案评估。在输注1升乳酸林格氏液后，分别在100立方厘米、250立方厘米、500立方厘米和759立方厘米时获取灌洗流出液样本，以及在不再有流出液回流时（最终样本）获取样本。如果钝性伤最终样本红细胞计数≤100,000/mm³且穿透伤＜50,000/mm³，则DPL被认为是阴性。结论是，当回流100立方厘米灌洗流出液时，阴性结果对DPL阴性具有高度预测性（98%），不过要统一预测DPL阴性则需要250立方厘米灌洗流出液（100%）。
