Role of serum alanine aminotransferase level combined with emergency bedside ultrasound in diagnosis of blunt hepatic trauma

Objective To evaluate the clinical value of alanine aminotransferase(ALT) test combined with emergency bedside ultrasound in the diagnosis of closed rupture of liver,and explore the early effective diagnosis. Methods A total of 105 cases of suspected blunt hepatic trauma from January,2013 to May,2015 in our hospital were enrolled into this study and received emergent ALT,bedside sonography and abdominal CT examinations,and 79 of them were confirmed by CT or operation(75.2%).The sensitivity,specificity and accuracy of ALT alone,bedside sonography,and a combination of those two methods for the diagnosis of blunt hepatic trauma were compared. Results The levels of ALT at 6 h,12 h and 24 h after admission in blunt hepatic trauma group were all significantly higher than those in the non-hepatic trauma group(t=8.43,9.17,7.54,P<0.05);The sensitivity,specificity and accuracy(area under curve) of ALT along by receiver operating curve(ROC) analysis were 88.6%,84.6% and 0.866;of single bedside sonography were 79.7%,92.3% and 0.860;and of the combined group were 98.7%,77.0% and 0.891,respectively. Conclusion ALT combined with emergency bedside ultrasound can greatly improve the diagnostic accuracy of blunt hepatic trauma,which shows an important role in the early diagnosis and treatment of blunt liver injury.