主页 > 医学新闻 >

【medical-news】超声在腹部钝伤的应用价值（胃肠

Hemodynamically stable patients with little or no free peritoneal fluid are observed with follow-up ultrasound or CT. Any free fluid detected in the pleural or pericardial spaces is regarded as hemothorax or hemopericardium and is managed accordingly. This arrangement is available only during the radiology department’s office hours (9 a.m. to 5 p.m.). At other times, the trauma team surgeons perform DPL or ultrasound scans according to the clinical indications. When sufficient data are available we will evaluate whether there is a difference in sensitivity of ultrasound performed by radiologists compared with surgeons.

Some studies have claimed that with formal training, surgeons can perform the examination with sensitivity comparable to that of radiologists. However, there is no agreement as to the standard format and length of training needed before a nonradiologist sonographer becomes competent.15-17 The proposed training period ranges from intensive courses of a few hours to three months’ direct supervision by radiologists. The preference in our hospital is for the radiologist to perform the scans. After office hours, it is advantageous for experienced clinicians to perform the scans themselves to avoid delay and obtain firsthand information. If radiologists are to maintain their active role in the management of blunt abdominal trauma, however, it is vital that the service be expanded to 24 hours a day.

In addition, subtle changes of parenchymal echotexture that may be the only hint of injury are easily missed by inexperienced sonographers, especially if the examination is hastily performed. Detection of free peritoneal fluid may be simple and obvious, but as already mentioned, clotted blood can be difficult to detect. The sensitivity of detecting parenchymal lacerations without free peritoneal fluid falls to about 70%, as compared to more than 90% in the presence of free fluid.12Retroperitoneal organs such as the pancreas are usually obscured by bowel gas, and hollow-viscus injury is difficult to detect even with CT. Acoustic windows may be limited by multiple open wounds and subcutaneous emphysema, and image quality may be suboptimal in morbidly obese patients.

阅读本文的人还阅读：

【medical-news】干细胞应用

【medical-news】大麻治疗骨

CT在胃癌诊断中的应用

应用5-氨基乙酰丙酸的荧

作者:admin@医学,生命科学    2010-10-25 05:11
医学,生命科学网