创伤重点超声评估法(FAST)在“5.12”汶川大地震早期伤员筛查中的运用
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摘要
目的总结"5.12"汶川大地震救治早期我院超声急诊筛查伤员腹部损伤情况,探讨创伤重点超声评估法(FAST)在地震救治早期的运用价值。方法震后初期(72小时内)共有587人接受了腹部超声检查,均采用创伤重点超声评估法。结果有16例伤员超声提示创伤性腹腔积液,后均经急诊手术证实;其中6例伤员超声提示了内脏损伤部位,4例超声定位正确,2例与术中探查损伤部位不符。FAST检查经证实的假阴性5例,术前及治疗中均无大量腹腔积液。结论运用便携式超声FAST具有便捷性、无环境限制、不需移动伤员、可与急救或专科检查同步进行等优点,且对于需紧急手术的腹部闭合损伤患者敏感性为100%,是震后早期最为重要的腹部闭合性损伤的筛查方法;但其不能作为腹部损伤的最终检查。
Objective To summarize the emergent ultrasound screeming of abdominal injuries of the wounded in the early rescue of Wenchuan Earthquake on May 12, 2008,and to explore the application value focused assessment of Sonography for trauma(FAST) in early earthquake rescue.Methods In total,587 wounded received ultrasound examination of abdomen in the first 72 hours after earthquake,and FAST was applied.Results Ultrasound examination indicated 16 cases had traumatic ascites,which was later confirmed by emergency operation;the visceral injury location was indicated by ultrasound examination in 6 cases,however,4 cases correct and 2 cases in inconformity to surgical exploration;5 negative cases by ultrasound examination were later proved to be false negative.Conclusions FAST is of such advantages as convenient and portable,no limit to environment,no need to move the wounded,and it is 100% sensitive to closed abdominal trauma which needs emergency operation;it was the most important screening method for closed abdominal trauma in the early rescue after the quake,but it couldn't be the final examination.
Objective To summarize the emergent ultrasound screeming of abdominal injuries of the wounded in the early rescue of Wenchuan Earthquake on May 12, 2008,and to explore the application value focused assessment of Sonography for trauma(FAST) in early earthquake rescue.Methods In total,587 wounded received ultrasound examination of abdomen in the first 72 hours after earthquake,and FAST was applied.Results Ultrasound examination indicated 16 cases had traumatic ascites,which was later confirmed by emergency operation;the visceral injury location was indicated by ultrasound examination in 6 cases,however,4 cases correct and 2 cases in inconformity to surgical exploration;5 negative cases by ultrasound examination were later proved to be false negative.Conclusions FAST is of such advantages as convenient and portable,no limit to environment,no need to move the wounded,and it is 100% sensitive to closed abdominal trauma which needs emergency operation;it was the most important screening method for closed abdominal trauma in the early rescue after the quake,but it couldn't be the final examination.
引文
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[2]Severe MS,Vanholder R,Lameire.Management of crush-related in-juries after disasters[J].N Engl J Med,2006,354:1052~1063.
[3]Michele A.Brown,Giovanna Casola,Claude B.Sirlin.Blunt Ab-dominal Trauma:Screening US in 2,693 Patients[J].Radiology2001,218:352~358.
[4]James T.Rhea,Daniel H.Garza,Robert A.Novelline.Controver-sies in emergency radiology.CTversus ultrasound in the evaluation ofblunt abdominal trauma[J].Emergency Radiology,2004,10:289~295.
[5]Fabian TC,Croce MA,Minard G,Bee TK,Cagiannos C,MillerPR,Stewart RM,Magnotti LJ,Patton JHJr.Current issues in trau-ma[J].Curr Probl Surg,2002,39:1160~1244.
[6]FAST Consensus Conference Committee.Focused assessment withsonography for trauma(FAST):results from an international consen-sus conference[J].J Trauma,1999,46:466~472.
[7]Pearl WS,Todd KH.Ultrasonography for the initial evaluation ofblunt abdominal trauma:a review of prospective trials[J].AnnEmerg Med,1996,27:353~361.
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