Rozycki G S, Ochsner M G, Jaffin J H, Champion H R
Washington Hospital Center--Trauma/Surgical Critical Care and Emergency Services, DC 20010.
J Trauma. 1993 Apr;34(4):516-26; discussion 526-7. doi: 10.1097/00005373-199304000-00008.
Ultrasound diagnostic imaging has been demonstrated to be a valuable investigative tool in the evaluation of trauma patients in Europe and Japan. In the United States, however, ultrasound has not been widely used by trauma surgeons because of its lack of availability in the trauma resuscitation area and the associated cost and lack of full-time availability of a technician. In this prospective study, four attending trauma surgeons, four trauma fellows (PGY 6 and 7), and 25 surgical residents (PGY 4) at a level I trauma center were trained in specific ultrasound techniques to identify fluid in trauma patients with thoracoabdominal injuries. Their ultrasound evaluations of 476 patients demonstrated that in 90 patients with clinically significant injuries, ultrasound imaging successfully detected injury in 71, for a 79% sensitivity. Specificity was 95.6%. We conclude that (1) surgeons can rapidly and accurately perform and interpret ultrasound examinations; and (2) ultrasound is a rapid, sensitive, specific diagnostic modality for detecting intraabdominal fluid and pericardial effusion.
在欧洲和日本，超声诊断成像已被证明是评估创伤患者的一种有价值的检查工具。然而，在美国，由于创伤复苏区域缺乏超声设备、相关成本以及缺乏技术员全职服务，创伤外科医生尚未广泛使用超声。在这项前瞻性研究中，一家一级创伤中心的四名主治创伤外科医生、四名创伤专科住院医师（第6和第7年住院医师）以及25名外科住院医师（第4年住院医师）接受了特定超声技术培训，以识别胸腹损伤创伤患者体内的液体。他们对476例患者的超声评估表明，在90例有临床显著损伤的患者中，超声成像成功检测出71例损伤，灵敏度为79%。特异性为95.6%。我们得出结论：（1）外科医生能够快速、准确地进行和解读超声检查；（2）超声是检测腹腔内液体和心包积液的一种快速、灵敏、特异的诊断方法。
