Author/Editor		Komadina, Radko; Smrkolj, Vladimir; Brilej, Drago
Title		Diagnostika topih poškodb trebuha
Translated title		Diagnostic procedures in blunt abdominal trauma
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 38, št. 4
Publication year		1999
Volume		str. 603-9
Language		slo
Abstract		Modern traumatology uses scoring systems to determine the efficiency of treatment. Surgeons employ a variety of diagnostic modalities for the assessment of blunt abdominal trauma, the choice of the modality depending on the severity of general status of the critically injured patient. Ninety-nine severely injured patients, included in the 3-year Slovenien Socfety of Trauma Surgeons Protocol of Sevarely Traumatised, were laparotomised because of blunt abdominal trauma. A retrograde analysis was used to determine the impact of the severity of trauma, as defined by the Revised Trauma Score (RTS) and the Injury Severity Score (ISS), on the diagnostic modality used to assess blunt abdominal trauma prior to undertaking laparotomy. The average ISS value was statistically significantly lower in patients with a positive ultrasonic diagnosis than in patients with a positive diagnostic peri- toneal lavage (p < 0.003). The average RTS value was significantly higher in patients with a positive ultrasound than in patients with positive results of diagnostic peritoneal lavage (p < 0.02). To save them time, surgeons evaluated gravely affected patients with severe abdominal trauma who had low RTS and high ISS scores by diagnostic peritoneal lavage which was performable simultaneously with the resuscitation procedure. Patients with clinically suspected blunt abdominal trauma, showing higher RTS and lower ISS scores were evaluated by ultrasound.
Summary		Izvleček. Sodobna travmatologija uporabija točkovne sisteme, s katerimi spremljamo uspešnost zdravljenja. Kirurgi uporabljajo različne diagnostične metode za diagnostiko topih poškodb trebuha, njihov izbor je pogojen s stopnjo splošne prizadetosti hudo poškodovanega bolnika. 99 hudo poškodovanih bolnikov, zajetih v triletnem vodenju Protokola za hudo poškodovane Društva travmatologov Slovenije, je bilo laparotomiranih zaradi tope poškodbe trebuha. Z retrogradno analizo so proučili vpliv teže poškodb, opredeljene z Revised trauma score (RTS) in Injury severity core (ISS), na način, kako je bila topa poškodba trebuha diagnosticirana pred laparotomijo. Povprečna vrednost ISS je bila pri bolnikih s pozitivnim ultrazvočnim izvidom statistično značilno nižja kot pri bolnikih s pozitivnim diagnostičnim izpiranjem potrebušnice (p<0,003). Poprečna vrednost RTS pri bolnikih s pozitivno ultrazvočno preiskavo trebuha je bila statistidno značilno višja od vrednosti pri bolnikih s pozitivnim diag- nostičnim izpiranjem trebušne votline (p < 0,02). Pri hudo prizadetih hudih poškodovancih so se kirurgi zaradi časovne stiske odločali za diagnostično izpiranje trebušne votline, ki jo je moč izvesti hkrati z reanimacijskim postopkom. Pri manj prizadetih bolnikih so klinično sumljivo topo poškodbo trebuha diagnosticirali z ultrazvokom.
Descriptors		ABDOMINAL INJURIES WOUNDS, NONPENETRATING INJURY SEVERITY SCORE LAPAROTOMY TOMOGRAPHY, X-RAY COMPUTED