腹部闭合性损伤致肠穿孔的超声诊断价值

发布时间：2018-03-02 08:59

本文关键词： 腹部损伤超声穿孔　出处：《中国医学计算机成像杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的:探讨腹部闭合性损伤致肠穿孔的超声诊断价值。方法:随机选取我院2006年1月-2014年8月间腹部闭合性损伤患者120例,其中术后病理证实肠穿孔患者48例,非肠穿孔患者72例,术前均在发病3小时内经超声及X线腹片检查。超声对120例患者以"双层气体征"及"小气泡征"方法进行腹腔游离气体的扫查,并与X线腹片检查结果进行对照;观察肠壁节段性或局部增厚、局部肠管的扩张及肠管麻痹征、肠间局限性积液、大网膜"包裹征"、"填塞征"及"聚集征"等征象且与术后病理结果相对照,判断是否存在肠穿孔。分析各种征象,评价其在诊断腹部闭合性损伤致肠穿孔中的敏感性及特异性。结果:48例肠穿孔患者中通过观察"双层气体征"及"小气泡征"发现腹腔游离气体44例(91.7%),高于X线发现膈下游离气体35例(72.9%,P0.05)。腹部闭合性损伤致肠穿孔的超声征象包括:膈下及腹壁下游离气体40例[敏感性83.3%(40/48),特异性100%(72/72)],肠间局限性积液内及组织周边"小气泡征"44例[敏感性91.7%(44/48),特异性98.6%(71/72)],肠壁节段性或局部增厚25例[敏感性52.1%(25/48),特异性97.2%(70/72)],及大网膜"包裹征"、"填塞征"及"聚集征"18例[敏感性37.5%(18/48),特异性95.8%(69/72)]。结论:超声在快速诊断腹部闭合性损伤致肠穿孔中具有较高的价值。
[Abstract]:Objective: to evaluate the value of ultrasonography in diagnosis of intestinal perforation caused by closed abdominal injury. Methods: one hundred and twenty patients with closed abdominal injury were randomly selected from January 2006 to August 2014. 72 patients with non-intestinal perforation were examined by ultrasonography and abdominal radiography within 3 hours before the onset of the disease. 120 patients were examined by double gas sign and small bubble sign. The results were compared with the results of abdominal radiography, and observed the segmental or local thickening of the intestinal wall, the dilatation of the local intestinal canal, the paralysis of the intestinal canal, the local effusion between the intestines. The "packing sign", "packing sign" and "aggregation sign" of omentum were compared with the postoperative pathological results to determine the existence of intestinal perforation. To evaluate its sensitivity and specificity in the diagnosis of intestinal perforation caused by closed abdominal injury results 44 cases of celiac free gas were found by observing "double gas sign" and "small bubble sign" in 48 cases of intestinal perforation, which was higher than X ray. The ultrasonic signs of intestinal perforation caused by closed abdominal injury include 40 cases of subphrenic and subabdominal free gas [sensitivity 83.3T 40 / 48, specificity 100% 72P 72 / 72], and "small bubble sign" in the local fluid and tissue around the intestine. Cases [sensitivity 91.7% 48%, specificity 98.66% 71 / 72], intestinal wall segmental or local thickening 25 cases [sensitivity 52.1% 25 / 48, specificity 97.2% 70 / 72], and omentum "wrapping sign", "packing sign" and "aggregation sign" 18 cases [sensitivity 37.51848%, specificity 95.8% -72]. Intestinal perforation caused by closed abdominal injury is of high value.
【作者单位】：开滦总医院林西医院超声科;开滦总医院林西医院外科;开滦总医院林西医院影像科;河北联合大学附属开滦医院超声科;开滦总医院唐家庄医院外科;开滦总医院林西医院检验科;
【分类号】：R445.1;R656

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