创伤重点超声评估法(fast)在“512”汶川大地震早期伤员筛查中的运用.docVIP

创伤重点超声评估法（FAST）在“5.12”汶川大地震早期伤员筛查中的运用 　　作者：陶杰,邓旦,梁燕,赖小今,吴晓波,常明　　作者单位：成都军区总医院超声科，四川 成都 　　【摘要】 目的 总结5.12汶川大地震救治早期我院超声急诊筛查伤员腹部损伤情况，探讨创伤重点超声评估法(FAST)在地震救治早 期的运用价值。方法 震后初期(72小时内)共有587人接受了腹部超声检查，均采用创伤重点超声评估法。结果 有16例伤员超声提示创伤性腹腔积液，后均经急诊手术证实;其中6例伤员超声提示了内脏损伤部位，4例超声定位正确，2例与术中探查损伤部位不符。FAST检查经证实的假阴性5例，术前及治疗中均无大量腹腔积液。结论 运用便携式超声FAST具有便捷性、无环境限制、不需移动伤员、可与急救或专科检查同步进行等优点，且对于需紧急手术的腹部闭合损伤患者敏感性为100%，是震后早期最为重要的腹部闭合性损伤的筛查方法;但其不能作为腹部损伤的最终检查。 　　【关键词】 地震 超声检查 创伤重点超声评估法 腹腔积液 　　The Application of Focused Assessment of Sonography for Trauma in the Early Screening of the Wounded in Wenchuan Earthquake 　　Tao Jie, Deng Dan Liang Yan, Lai Xiaojin, Wu Xiaobo, Chang Ming, Liao Mingsong, Chengdu Military General Hospital, Chengdu, Sichuan Province 610083 　　Abstract Objective To summarize the emergent ultrasound screeming of abdominal injuries of the wounded in the early rescue of Wenchuan Earthquake on May 12, 2008, and to explore the application value focused assessment of Sonography for trauma (FAST) in early earthquake rescue.Methods In total, 587 wounded received ultrasound examination of abdomen in the first 72 hours after earthquake, and FAST was applied.Results Ultrasound examination indicated 16 cases had traumatic ascites, which was later confirmed by emergency operation; the visceral injury location was indicated by ultrasound examination in 6 cases, however, 4 cases correct and 2 cases in inconformity to surgical exploration; 5 negative cases by ultrasound examination were later proved to be false negative.Conclusions FAST is of such advantages as convenient and portable, no limit to environment, no need to move the wounded, and it is 100% sensitive to closed abdominal trauma which needs emergency operation; it was the most important screening method for closed abdominal trauma in the early rescue after the quake, but it couldnt be the final examination. 　　KEYWORDS earthquake ultrasound examination FAST ascites 　　地震作为大规模伤亡事件(Mass Casualty Incident,MCI)，其特征是伤亡事件