便携式超声在汶川地震伤员救治中的应用价值
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摘要
目的探讨便携式超声在汶川地震伤员救治中的应用价值。方法回顾性分析了便携式超声在我院汶川地震伤员救治中的应用范围、应用方法和具体作用。结果医院共接诊地震伤员3307例,超声检查共计1386例次,应用便携式超声仪检查例次占75.4%(1045/1386)。震后初期(地震发生后15min～72h)全部地震伤员的超声检查均采用便携式超声,地震中后期(震后72h～6周)采用便携式超声的床旁超声检查占超声检查总量的73.87%(458/620)。其中部分超声检查为超声引导下介入诊断或治疗。便携式超声共筛查出腹腔积血14例,胸腔积液(血)34例,骨折后下肢深静脉血栓2例,肢体软组织深部血肿6例,监测了7例挤压综合症患者浆膜腔积液及肾脏体积和血流灌注变化。创伤相关病变的便携式超声阳性检出率为6%(63/1045),没有发现假阳性,假阴性率为0.51%(5/982)。结论便携式超声在地震初期伤员的分诊、中后期重症伤员的床旁检查以及介入诊疗中发挥了重要作用。
Objective To explore the value of portable sonographic device in the treatment of the Wounded after Wenchuan earthquake.Methods In a retrospective study,the article analyzes the application scope,application method and detailed effect of portable sonographic devices used by our hospital in the treatment of the wounded after Wenchuan earthquake.Results Our hospital altogether admits 3307 wounded people after the earthquake,among which,1386 are examined by sonographic devices,while 75.4%(1045/1386) of which is examined by portable sonographic devices.During the initial period after the earthquake(15 min～72h),all the wounded are examined by portalbe sonographic devices;during the middle and later period after the earthquake(72h～6 week),among all the wounded examined bedside by sonographic devices,73.87%(458/620) of which is examined by portable sonographic devices,and some of which are diagnosticated and treated with the guidance of sonogaphic devices.The portable sonographic devices find out 14 cases of hemoperitoneum,34 cases of pleural effusion(hemothorax),2 cases of DVT and 6 cases of soft tissue deep hematoma;besides,the portable sonographic devices also monitor the change of serous cavity effusion,renal volume and blood flow perfusion in 7 cases of crush syndrome patients.The positive rate of trauma-combined syndrome detected by portable sonographic devices is 6%(63/1045),and there is not a single case of false positive,and the false negative rate is 0.51%(5/982).Conclusion The portable sonographic device plays an important role in the pre-diagnosis for the wounded in the intital post-earthquake period,in the bedside examination of the severely wounded in the middle and later period,and in the interventional treatment.
Objective To explore the value of portable sonographic device in the treatment of the Wounded after Wenchuan earthquake.Methods In a retrospective study,the article analyzes the application scope,application method and detailed effect of portable sonographic devices used by our hospital in the treatment of the wounded after Wenchuan earthquake.Results Our hospital altogether admits 3307 wounded people after the earthquake,among which,1386 are examined by sonographic devices,while 75.4%(1045/1386) of which is examined by portable sonographic devices.During the initial period after the earthquake(15 min～72h),all the wounded are examined by portalbe sonographic devices;during the middle and later period after the earthquake(72h～6 week),among all the wounded examined bedside by sonographic devices,73.87%(458/620) of which is examined by portable sonographic devices,and some of which are diagnosticated and treated with the guidance of sonogaphic devices.The portable sonographic devices find out 14 cases of hemoperitoneum,34 cases of pleural effusion(hemothorax),2 cases of DVT and 6 cases of soft tissue deep hematoma;besides,the portable sonographic devices also monitor the change of serous cavity effusion,renal volume and blood flow perfusion in 7 cases of crush syndrome patients.The positive rate of trauma-combined syndrome detected by portable sonographic devices is 6%(63/1045),and there is not a single case of false positive,and the false negative rate is 0.51%(5/982).Conclusion The portable sonographic device plays an important role in the pre-diagnosis for the wounded in the intital post-earthquake period,in the bedside examination of the severely wounded in the middle and later period,and in the interventional treatment.
引文
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[2]Christine S,Schulman.A FASTer method of detecting abdominal trauma[J].Nusring Management,2003,9:47～49
[3]Severe MS,Vanholder R,Lameire.Management of crush-related injuries after disasters[J].NEngl J Med,2006,354:1052～1063
[4]Lee BC,Ormsby EL,McGahan JP,et al.The utility of sonography for the triage of blunt abdominal trauma patientsto exploratorylaparotomy[J].Am J Roentgenol,2007,188:415～421
[5]Brenchler J,Walker A,Sloan JP,et al.Evaluation of focused assessment with sonographyintrauma(FAST)by UKemergency physician[J].EmergMed J,2006,23:446～448
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