龚英姿 贺建锋 薛冰

摘 要：目的 探讨超声检查在诊断闭合性腹外伤中的应用价值。方法 回顾性分析2013年1月～2018年1月在我院经超声检查后手术证实或CT证实的106例闭合性腹外伤患者的声像图表现。结果 106例闭合性腹外伤中95例超声探查到腹腔游离液体，均经手术证实为腹腔脏器挫裂，其中脾挫裂65例，包括延迟性脾挫裂12例，占脾挫裂18.46%。7例误诊，其中肝挫裂伤1例，复合挫裂伤3例，小肠挫裂伤3例。超声诊断与手术符合率为92.63%。11例超声未探及游离液体，均经手术或CT证实为腹腔脏器挫伤或血肿。结论 超声检查对腹腔游离液体检出在闭合性腹外伤的诊断中发挥着重要的作用。

关键词：闭合性腹外伤；超声诊断；腹腔游离液体

中图分类号：R445.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.20.052

文章编号：1006-1959（2018）20-0166-02

Abstract：Objective To investigate the value of ultrasonography in the diagnosis of closed abdominal trauma.Methods A retrospective analysis of the sonographic findings of 106 patients with closed abdominal trauma who were confirmed by surgery or confirmed by CT in our hospital from January 2013 to January 2018.Results Of the 106 patients with closed abdominal trauma，94 patients underwent ultrasonography to detect free fluid in the abdominal cavity.All of them were confirmed by surgery as abdominal contusion.Among them，65 cases were spleen contusion，including 12 cases of delayed spleen contusion，accounting for 18.46% of spleen contusion.7 cases were misdiagnosed，including 1 case of hepatic contusion and laceration，3 cases of compound contusion and laceration，and 3 cases of small intestine contusion.The coincidence rate between ultrasound diagnosis and surgery was 92.55%.11 cases of ultrasound were not explored and free fluid，which was confirmed by surgery or CT as abdominal contusion or hematoma. Conclusion Ultrasonography plays an important role in the detection of free abdominal fluid in the diagnosis of closed abdominal trauma.

Key words：Closed abdominal trauma；Ultrasound diagnosis；Free fluid in the abdominal cavity

閉合性腹外伤是由交通、工伤事故等原因所致的急重症疾病，来势多较凶猛，如不能及时确诊，易造成后期治疗困难。我院地处国家重点开发项目之一的宁东能源化工基地，巨大的施工建设生产规模，使腹外伤事件明显上升，为提高本地区闭合性腹外伤患者的确诊率，为急诊患者的救治赢得宝贵时间，本研究特选取经超声检查后手术证实或CT证实的105例闭合性腹外伤患者进行分析，报告如下。

1 资料与方法

1.1一般资料 收集了2013年1月～2018年1月宁夏回族自治区宁东医院106例因交通事故、高空坠落、挤压等所致的闭合性腹外伤患者，年龄11～62岁，平均年龄（37.23±9.28）岁，其中男86例，女19例，所有患者均行常规超声全腹探查，其中经临床手术证实闭合性腹外伤96例，经CT检查证实闭合性腹外伤、临床保守治疗9例。……