一位37岁男性工人从工地掉下来,理学检查时病人意识清楚,但发现尿道口有血迹,而且 阴囊有血肿,会阴有瘀伤,接下来你最先要安排何种检查? A. Intravenous pyelogram B. cystography C. retrograde urethrogram D. contrast-enhanced CT 考选部答案: C 建议答案: C.D皆对 以下资料摘录自Sabinston textbook of surgery chapter 20 -management of acute trauma- abdominal trauma-pelvic fracture <<Injuries to the Urethra>> Disruption of the urethra is a rare injury in women. It is found mostly in men, """frequently after either pelvic fractures or straddle injuries""". <<Pelvic Fractures>> Unstable pelvic fractures are accompanied, most of the time, by """major retroperitoneal hemorrhage"""…. CT scan of the pelvis provides information on displacement of the sacroiliac joint, acetabular fractures, and sacral fractures; however it should not be performed in a hemodynamically unstable patient. Because of the high incidence of associated intra-abdominal injuries, supraumbilical DPL should be performed; however there is an approximately 35% rate of false-positive results with DPL in the presence of retroperitoneal hematoma. """Stable patients are best evaluated with an abdominal CT scan.""" 依上述,病人的意识状态清楚,应属於hemodynamically stable,且怀疑pelvic fracture 应该要做abdominal CT吧?! --

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