New diagnostic peritoneal lavage criteria for diagnosis of intestinal injury.
New diagnostic peritoneal lavage criteria for diagnosis of intestinal injury.
复制标题
诊断肠道损伤的新腹腔灌洗诊断标准。
DOI：
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Y. Yamamoto
中科院分区：
文献类型：
--
作者：
Y. Otomo;H. Henmi;K. Mashiko;K. Kato;K. Koike;Y. Koido;A. Kimura;M. Honma;J. Inoue;Y. Yamamoto
背景
虽然诊断性腹腔灌洗（DPL）是一种公认的、可靠的诊断腹腔损伤的客观方法，但它太敏感而不能作为急诊剖腹手术的指标。因此，由于超声和先进的计算机断层扫描仪的发展，DPL的作用已显着减少。尽管有这些显著的进步，但是，肠损伤的放射学诊断并不能总是提供明确的结果，DPL在这种情况下仍然有价值。我们已经开发了一种新的DPL标准，专门用于帮助诊断肠损伤，并评估其有效性。
方法
从1988年8月至1995年12月，我们对250例闭合性腹部创伤患者进行了DPL检查，并分析了我们的新标准的诊断准确性。我们使用标准的定量白色血细胞（WBC）标准检测肠损伤，并将阳性-阴性边界调整为WBC >或=红细胞（RBC）/150，其中RBC >或= 10 × 10（4）/mm 3。
结果
我们的标准有96.6%的诊断敏感性和99.4%的特异性为肠损伤后，排除了57例患者中，DPL进行3小时内或18小时后，从受伤的时间。在133例腹腔积血患者中，仅48例进行了紧急剖腹术;其余85例根据WBC标准DPL阴性的患者避免了手术，保守治疗未导致并发症。
结论
根据提出的标准，即使在存在腹腔积血的情况下，DPL也可用于诊断或排除肠损伤。
BACKGROUND
Although diagnostic peritoneal lavage (DPL) is a well-established, reliably objective method of diagnosis of intraperitoneal injury, it is too sensitive to be used as an indicator for emergency celiotomy. Therefore, since the development of ultrasonography and advanced computed tomographic scanners, the role of DPL has been markedly reduced. Despite such remarkable advances, however, radiologic diagnosis of intestinal injury cannot always provide definitive results, and DPL may still be valuable in such instances. We have developed a new DPL criteria specifically designed to aid in the diagnosis of intestinal injury and have evaluated its effectiveness.
METHODS
From August 1988 to December 1995, we performed DPL in 250 patients with blunt abdominal trauma and analyzed the diagnostic accuracy of our new criteria. We used the standard quantitative white blood cell (WBC) criterion for detection of intestinal injury supplemented by a positive-negative borderline adjusted to WBC > or = red blood cell (RBC)/150, where RBC > or = 10 x 10(4)/mm3.
RESULTS
Our criteria had a diagnostic sensitivity of 96.6% and a specificity of 99.4% for intestinal injury after exclusion of 57 patients in whom DPL was performed within 3 hours or after 18 hours from the time of injury. In 133 patients with hemoperitoneum, emergency celiotomy was performed in only 48; the remaining 85 patients with negative DPL based on the WBC criterion avoided surgery, and conservative management resulted in no complications.
CONCLUSION
With the proposed criteria, DPL can be used to diagnose or exclude intestinal injury even in the presence of hemoperitoneum.
腹部钝性创伤的腹腔灌洗。
DOI：
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发表时间：
1981
期刊：
Surgery, gynecology & obstetrics
影响因子：
--
作者：
Krausz,MM;Manny,J;Utsunomiya,T;Hechtman,HB
通讯作者：
Hechtman,HB