Rozycki G S, Ochsner M G, Feliciano D V, Thomas B, Boulanger B R, Davis F E, Falcone R E, Schmidt J A
Department of Trauma/Surgical Critical Care, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia 30303, USA.
J Trauma. 1998 Nov;45(5):878-83. doi: 10.1097/00005373-199811000-00006.
The focused assessment for the sonographic examination of the trauma patient (FAST) is a rapid diagnostic test that sequentially surveys for hemopericardium and then the right upper quadrant (RUQ), left upper quadrant (LUQ), and pelvis for hemoperitoneum in patients with potential truncal injuries. The sequence of the abdominal part of the examination, however, has yet to be validated. The objectives of this multicenter study were as follows: (1) to determine where hemoperitoneum is most frequently identified on positive FAST examinations; and (2) to determine if a relationship exists between that areas and the organs injured.
Ultrasound registries from four Level I trauma centers identified patients who had true-positive FAST examinations. Demographic data, areas positive on the FAST, and organs injured were recorded; injuries were classified as multiple, single solid organ (liver or spleen), isolated hollow viscus, or retroperitoneal. Relationships between positive locations on the FAST examinations and the associations of organs injured to areas positive were assessed using McNamara's chi2 test; a p value < 0.05 was considered statistically significant.
The RUQ was the most common site where hemoperitoneum was detected, and this was statistically significant compared with either the LUQ or the pelvis. Also, statistically significant correlations (p < 0.001) were observed between positive RUQ areas on the FAST and multiple injuries, single solid organ (liver or spleen) injury, and retroperitoneal injuries.
Blood is most often found on the FAST in the RUQ area in patients with multiple intraperitoneal injuries or isolated injury to the liver, spleen, or retroperitoneum, but not when there is injury to a hollow viscus.
创伤患者超声重点评估（FAST）是一项快速诊断检查，用于对可能存在躯干损伤的患者依次检查心包积血，然后检查右上腹（RUQ）、左上腹（LUQ）和骨盆有无腹腔积血。然而，检查腹部部分的顺序尚未得到验证。这项多中心研究的目的如下：（1）确定在阳性FAST检查中腹腔积血最常被发现的部位；（2）确定该部位与受损器官之间是否存在关联。
来自四个一级创伤中心的超声登记处确定了FAST检查结果为真阳性的患者。记录人口统计学数据、FAST检查阳性的部位以及受损器官；损伤分为多发、单个实体器官（肝脏或脾脏）、孤立的中空脏器或腹膜后损伤。使用麦克纳马拉卡方检验评估FAST检查阳性部位与受损器官和阳性部位之间的关联；p值<0.05被认为具有统计学意义。
RUQ是检测到腹腔积血最常见的部位，与LUQ或骨盆相比具有统计学意义。此外，在FAST检查中RUQ阳性区域与多发损伤、单个实体器官（肝脏或脾脏）损伤和腹膜后损伤之间观察到具有统计学意义的相关性（p<0.001）。
在腹腔内多发损伤或肝脏、脾脏或腹膜后孤立损伤的患者中，FAST检查最常发现血液位于RUQ区域，但中空脏器损伤时则不然。
