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超声与常规CT在腹部闭合性损伤中的临床诊断价值
Clinical Value of Ultrasound and Conventional Computed Tomography Examinations in the Diagnosis of Closed Abdominal Injury

张艳艳.超声与常规CT在腹部闭合性损伤中的临床诊断价值[J].中国烧伤创疡杂志,2021,(5):358~360.

DOI：

英文关键词:Abdominal injury Closed injury Diagnosis Ultrasound CT Injury grading

基金项目:

作者	单位
张艳艳	安阳县人民医院超声科

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中文摘要:

【摘要】目的探讨超声与常规CT 在腹部闭合性损伤中的诊断价值。方法选取2019 年2月至2020年3月安阳县人民医院收治的64例腹部闭合性损伤患者作为研究对象，所有患者均接受超声及常规CT检查，对比观察两种检查方式对创伤类型的诊断准确率、创伤分级的判定符合率及诊断耗费时间。结果超声检查诊断肾挫裂伤、肝挫裂伤、脾挫裂伤的准确率分别为91.67%、82.61%、95.12%，明显高于常规CT检查的诊断准确率50.00%、52.17%、80.49% (χ2=5.042、4.847、4.100，P =0.025、0.028?0.043)；诊断腹腔积液的准确率为93.75%，明显低于常规CT检查的诊断准确率100%(χ2=4.129，P=0.042)。超声检查对Ⅰ级、Ⅱ级、Ⅲ级及以上脏器损伤程度的判定符合率为90.00%、90.91%、100%，均明显高于常规CT检查的判定符合率60.00%、60.61%、54.55% (χ2=4.800、5.639、6.471，P = 0.028、0.018?0.011)。超声检查的检查前时间、获得结果时间及总时间均明显短于常规CT检查(t =19.212、31.339、39.199，P均<0.001)，而检查过程时间明显长于常规CT检查(t =11.556，P <0.001)。结论超声检查对肝、肾、脾等实质性脏器损伤的诊断准确率更高，且检查时间较短，能够为救治患者争取更多宝贵时间。

英文摘要:

【Abstract】 Objective To study the clinical value of ultrasound and conventional computed tomography (CT) examinations in the diagnosis of closed abdominal injuries. Methods 64 patients with closed abdominal injuries, admitted to Anyang County People’s Hospital between February 2019 and March 2020, were enrolled in the study. All patients underwent both ultrasound scan and conventional CT examination. Accuracy in identifying type of abdominal injury, accuracy in classifying grade of injury, and time for diagnosis were compared between the two methods. Results Comparison on accuracy in contusion diagnosis between the two methods (Ultrasound vs. CT): kidney contusion (91. 67% vs.50.00%), liver contusion (82.61% vs.52.17%), and spleen contusion (95.12% vs.80.9%) (χ2=5.042, 4.847 and 4.100,P =0.025, 0.028 and 0.043). Comparison on accuracy in ascites diagnosis between the two methods (Ultrasound vs.CT): 93. 75% vs.100% (χ2 =4.129, P=0.042). Comparison on accuracy in the classification of grade of visceral organ damage between the two methods (Ultrasound vs.CT): grade Ⅰ (90.00% vs.60.00%), grade Ⅱ (90.91% vs.60.61%) and grade Ⅲ (100% vs.54.55%) (χ2= 4.800, 5. 639 and 6. 471, P = 0.028, 0.018 and 0.011). The duration of preparation before scan, time of result analysis and the total time of Ultrasound examination were all significantly shorter than conventional CT examination (t =19.212, 31.339 and 39.199, all P <0.001), while the scanning duration of ultrasound scan was significantly longer than conventional CT scan (t =11.556, P <0.001). Conclusion Compared with conventional CT examination, ultrasound examination shows higher accuracy in the diagnosis of parenchymal injuries of visceral organs like liver, kidney and spleen, and has a shorter total examination time, which is critical to saving patients’lives.