吴华雯

[摘要] 目的 探讨B超在腹部闭合性损伤诊断中的应用效果观察。方法 回顾性分析2016年3月—2017年3月在该院治疗的130例腹部闭合性损伤患者的临床资料，均通过手术操作确诊，术前使用B超检查，将B超结果与手术结果进行比较，分析B超在腹部闭合性损伤诊断中的应用效果。 结果 B超确诊113例，确诊率为86.92%，不符17例，漏诊率为13.08%；其中，实质性脏器损伤99例，确诊89例，确诊率为89.90%；非实质性脏器损伤31例，确诊24例，确诊率为77.42%，两者差异有统计学意义（P<0.05）；漏诊病例中，实质性脏器损伤10例（10.10%），分别为脾脏损伤7例，肝脏损伤2例，胰脏损伤1例；非实质性脏器损伤7例（22.58%），分别为肠穿孔2例，卵巢囊肿破裂4例，肠系膜血管撕裂伤1例。结论 B超在腹部闭合性损伤诊断中准确性较高，尤其是在实质性脏器损伤的诊断中具有较高临床价值，非实质性脏器损伤需结合CT检查加以明确。

[关键词] 腹部闭合性损伤；B超；诊断；应用效果

[中图分类号] R722.12 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0182-03

[Abstract] Objective To study the application effect of B ultrasound in the diagnosis of abdominal closed trauma. Methods 130 cases of patients with abdominal closed trauma admitted and treated in our hospital from March 2016 to March 2017 were selected and confirmed by the operation， and the patients applied the B ultrasound examination before operation， and the B ultrasound examination results and operation results were compared and the application effect of B ultrasound in the diagnosis of abdominal closed trauma was analyzed. Results 113 cases were confirmed by the B ultrasound， and the confirmation rate was 86.92%， and 17 cases were not consistent， and the missed diagnosis rate was 13.08%， including 99 cases with injury of parenchymatous organ and 89 cases were confirmed and the confirmation rate was 89.90%， 31 cases with non-substantial organ injury， 24 cases were confirmed and the confirmation rate was 77.42%， and the difference was statistically significant，P<0.05， in the missed diagnosis cases， there were 10 cases with injury of parenchymatous organ （10.10%）， including 7 cases with spleen hurt， 2 cases with liver injury and 1 case with pancreas injury， and there were 7 cases with non-substantial organ injury （22.58%）， including 2 cases with enterobrosis， 4 cases with rupture of oophoritic cyst and 1 case with omphalomesenteric vessel laceration. Conclusion The accuracy of B ultrasound in the diagnosis of abdominal closed trauma is higher， especially the clinical value in the diagnosis of injury of parenchymatous organ is high， and the examination of non-substantial organ injury should be confirmed combined with the CT examination.

[Key words] Abdominal closed trauma； B ultrasound； Diagnosis； Application effect

腹部閉合性损伤伤口闭合，无法直接检查，且临床表现多种多样，属于临床常见急腹症。需要临床及时准确的判断内脏有无破裂出血，定位内脏出血部位，判断出血量，以便迅速做出诊治方案。临床检查以B超最为常见，通过显示腹腔脏器的形态、大小、内部回声，并显示脏器与周围组织的关系，来判断腹部闭合性损伤严重程度，因此B超检查有重要的诊断作用[1]。该研究方便选择该院2016年3月—2017年3月在该院治疗的130例腹部闭合性损伤患者，进一步分析B超在腹部闭合性损伤诊断中的应用效果，现报道如下。

1 资料与方法

1.1 一般资料

回顾性分析方便选取在该院治疗的130例腹部闭合性损伤患者的临床资料，男71例，女59例，年龄24～78岁，平均年龄（45.4±8.3）岁；所有患者均有明确的腹部外伤史，于伤后30 min～3 d内就诊，临床表现为腹部疼痛，伴有不同程度腹胀、恶心呕吐，严重者甚至失血性休克；……