Blunt bowel and mesenteric injuries: The role of screening computed tomography
Blunt bowel and mesenteric injuries: The role of screening computed tomography
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DOI：
10.1097/00005373-200006000-00001
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发表时间：
2000-06-01
影响因子：
--
通讯作者：
Croce, MA
中科院分区：
文献类型：
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作者：
Malhotra, AK;Fabian, TC;Croce, MA
背景：早期的扫描仪在检测钝性肠道/肠系膜损伤（BBMI）时敏感性较差。本研究旨在确定螺旋扫描仪在BBMI检测中的准确性及其作用。
方法：对1995年8月至1998年12月期间患有BBMI或计算机断层扫描（CT）怀疑有BBMI的患者进行回顾性图表分析。
结果：8112次扫描中有100次（1.2%）怀疑有BBMI。在这些可疑扫描中，53例患者有BBMI（真阳性 - TP），47例患者没有（假阳性 - FP）。7例扫描结果为阴性的患者有BBMI（假阴性 - FN）。计算机断层扫描促使77%可能会延迟手术的患者早期进行了手术。6例患者发生了腹腔内脓肿。脓肿组从受伤到手术的时间间隔明显更长。57%的真阳性扫描中发现多种异常表现，而在13%的假阳性扫描中发现多种异常表现（p < 0.0001）。提出了一种BBMI的处理算法。
结论：螺旋扫描仪在检测BBMI方面具有较高的准确性。单一表现与多种表现对于处理这些损伤是有用的。
Background: Early generation scanners have demonstrated poor sensitivity detecting blunt bowel/mesenteric injuries (BBMI). This study was aimed at determining the accuracy and role of helical scanners in BBMI.Methods: Retrospective chart review of patients with BBMI, or computed tomographic scans suspicious of BBMI, from August of 1995 to December of 1998.Results: One hundred of 8,112 scans (1.2%) were suspicious of BBMI, Of these suspicious scans, 53 patients had BBMI (true positive-TP) and 47 patients did not (false positive-FP). Seven patients with negative scans had BBMI (false negative-FN). Computed tomography contributed toward early surgery in 77% of patients who may have been delayed. Six patients developed intra-abdominal abscess. The abscess group had a significantly longer time interval from injury to surgery. Multiple findings were seen in 57% of true positive scans, whereas in 13% of false positive scans (p < 0.0001), An algorithm for management of BBMI is presented.Conclusion: Helical scanners have high accuracy in detecting BBMI, Single versus multiple findings are useful in managing these injuries.