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目的探讨意外创伤和急性疾病患者在最短时间内得到及时诊断和有效救治。方法应用Acuson128XP/10c彩色多普勒超声诊断仪,对66例均有突发性剧烈腹痛、胸部疼痛等症状的患者作超声检查。结果66例急诊超声诊断与临床诊断符合56例:外伤性胸膜腔积血6例、肝脏破裂1例、脾脏破裂8例、肾脏破裂3例,胆结石嵌顿并急性胆囊炎3例、胆总管结石梗阻1例、急性胰腺炎2例、输尿管结石2例、尿道膜部结石3例、肠梗阻3例、腹股沟疝1例、宫外孕23例,占84.83%(56/66);基本符合8例:外伤性肠破裂4例、肠系膜静脉破裂2例,急性坏疸性胆囊炎并穿孔1例、胃溃疡穿孔1例,占12.1%(8/66);误诊1例,为黄体破裂,占1.52%(1/66);漏诊1例,为肠系膜上动脉栓塞,占1.52%(1/66)。结论超声检查能为意外创伤和急性疾病患者赢得及时确诊和有效的救治空间,在很大程度上避免了漏诊和误诊或盲目剖腹探查,尤其在胸腹部创伤或急腹症救治体系中显得非常重要,对促进医疗急救提速有着重要的应用价值。
Objective To investigate the timely diagnosis and effective treatment of patients with accidental trauma and acute diseases in the shortest time. Methods Acuson128XP / 10c color Doppler ultrasonic diagnostic apparatus, 66 cases of sudden severe abdominal pain, chest pain and other symptoms in patients with ultrasound examination. Results The diagnostic and clinical diagnosis of 66 cases were in accordance with 56 cases: traumatic pleural hemorrhage in 6 cases, liver rupture in 1 case, splenic rupture in 8 cases, renal rupture in 3 cases, gallstone incarceration and acute cholecystitis in 3 cases, common bile duct 1 case of stone obstruction, 2 cases of acute pancreatitis, ureteral calculi in 2 cases, 3 cases of urethral membranous calculi, 3 cases of intestinal obstruction, 1 case of inguinal hernia, 23 cases of ectopic pregnancy, accounting for 84.83% (56/66); basically consistent with 8 cases : 4 cases of traumatic intestinal rupture, 2 cases of mesenteric vein rupture, acute jaundice cholecystitis and perforation in 1 case, gastric ulcer perforation in 1 case, accounting for 12.1% (8/66); misdiagnosed in 1 case, corpus luteum rupture, accounting for 1.52 % (1/66); missed diagnosis in 1 case, superior mesenteric artery embolization, accounting for 1.52% (1/66). Conclusion Ultrasound can win timely diagnosis and effective treatment space for patients with accidental trauma and acute diseases. To a large extent, it is very important to avoid misdiagnosis or blind laparotomy, especially in the treatment of thoracoabdominal trauma or acute abdomen. , Has the important application value to promote the medical emergency speed.