钝性腹部创伤严重程度评分系统:钝性腹部创伤管理的特殊评分

Jaimin D Shah, Tapan A Shah, Jatinkumar B Modi
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摘要

目的腹部是诊断的黑匣子。腹部的体格检查在做出这一判断时是不可靠的,有时由于患者药物或酒精的影响或腹部损伤合并头部或脊髓损伤而难以进行临床评估。然而,腹部僵硬或血流动力学损伤的存在是一个及时手术探查的指征。对于其余的患者,各种诊断辅助工具被用来识别腹部损伤。在本研究中,我们的目的是找到这些问题的答案,(1)每个病例的主要手术指征是什么?(2)患者延迟进入手术室是否影响手术结果?(3)如何在钝性腹部创伤严重程度评分系统(BATSS)的要求下发现钝性腹部损伤的发病率和死亡率。材料与方法回顾性分析艾哈迈达巴德纳伦德拉莫迪医学院Sheth Lallubhai Gordhandas市属总医院100例钝性腹部创伤患者的BATSS评分准确性。根据BATSS评分将患者分为3组:(1)≥12分组,(2)8 ~ 11分组,(3)<8分组。结果高危组多采用手术治疗,低危组在专家指导下保守治疗。手术组和保守组的平均BATSS评分分别为14.77±2.91分和5.12±2.56分。BATSS评分的特异性为87.1%,敏感性为100%,阴性预测值(NPV)为94.5%,阳性预测值(PPV)为100%,总体准确率为96%。结论BATSS对分诊有重要意义,是识别和抢救腹部钝性损伤高危患者的良好工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Blunt Abdominal Trauma Severity Scoring System: Exceptional score in Blunt Abdominal Trauma Management
Objectives The abdomen is a diagnostic black box. Physical examination of the abdomen is unreliable in making this determination, and sometimes clinical evaluation is difficult due to the influence of drugs or alcohol by patients or abdominal injuries occurring with head or spinal cord injuries. However, the presence of abdominal rigidity or hemodynamic compromise is an indication for prompt surgical exploration. For the remainder of patients, a variety of diagnostic adjuncts are used to identify abdominal injury. In this study, our aim is to find the answer of these questions, (1) What was the major indication for operation in each case? (2) Did delays in getting the patient to the operating room affect the outcome? (3) How to find morbidity and mortality in blunt abdominal injuries, at the behest of the Blunt Abdominal Trauma Severity Scoring System (BATSS). Materials and Methods A retrospective study of 100 cases of blunt abdominal trauma was done at Sheth Lallubhai Gordhandas Municipal General Hospital, Narendra Modi Medical College, Ahmedabad, for the accuracy of the BATSS score. Patients were divided into three groups according to the BATSS: (1) ≥12 score group, (2) 8–11 score group, and (3) <8 score group. Results Operative management was more common in the high-risk group, while the low-risk group was managed conservatively under expert guidance. The mean BATSS scores in operative and conservative management were 14.77 ± 2.91 and 5.12 ± 2.56, respectively. The BATSS score had an 87.1% Specificity, 100% Sensitivity, 94.5% Negative predict value (NPV), 100% Positive predict value (PPV) and an overall Accuracy of 96%. Conclusion BATSS is important for triage and is an excellent tool for recognising and picking up high-risk patients with blunt abdominal injuries.
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