自动超声容积断层扫描和传统超声检查诊断腹外疝的临床研究

发布时间：2018-05-31 21:55

本文选题：超声诊断 + 自动超声容积断层扫描　；参考：《复旦大学》2012年硕士论文

【摘要】：本课题通过回顾性分析研究传统超声检查和自动超声容积断层扫描在围手术期诊断腹外疝的应用价值,并进一步比较两种检查在腹外疝不同分类中的诊断优势,旨在为临床提供最有效、最简单、最快捷的影像诊断依据。第一部分：研究传统超声检查对腹股沟疝手术前后评估的价值。方法：对30名患者32例腹股沟疝于手术前后进行二维超声检查。术前观察内环位置、腹股沟管内径改变、疝囊大小及内容物并对腹股沟疝类型进行分类；术后观察补片位置、大小、形态及生物补片与四周组织的融合情况。结果：在32例病例中,有20例斜疝、4例直疝、3例股疝术前的超声诊断与手术结果相符。术后一个月内超声检查发现,其中28例见正常生物补片、未见其他异常回声,2例见补片外血肿,1例见补片外复发疝,1例见补片变形。结论：在腹股沟疝手术前,通过超声检查能为临床医生提供腹股沟疝形态的详细参考数据并为腹股沟疝分类,为临床医生选择适合患者个体的生物补片提供了重要的客观依据。在腹股沟疝手术后,超声检查能观察生物补片的形态、位置及有无发生其它并发症。第二部分：研究自动超声容积断层扫描在腹外疝分类诊断中的应用价值。方法：术前对62例疑似腹外疝进行自动超声容积断层扫描(简称AUVS)检查,通过AUVS的任意切面(横断面、矢状面、冠状面)对扫查区域的立体结构、疝环位置、疝囊、疝内容物及回纳途径进行观察,诊断出腹外疝的类型,并将诊断结果与术后诊断进行比较。结果：在对腹外疝病例的诊断分类中,AUVS对腹壁切口疝的诊断正确率高于AUVS对腹股沟疝的诊断；AUVS对难复性腹股沟疝的诊断正确率高于AUVS对可复性腹股沟疝的诊断。结论：AUVS显示的组织冠状面图像,能为临床医生提供了立体三维的客观影像学数据；在腹外疝的诊断分类中,AUVS对腹壁切口疝和难复性腹股沟疝的诊断可给予明确的影像学支持依据。第三部分：通过临床研究,比较自动超声容积断层扫描和传统超声检查在腹外疝中分类诊断的应用优势。方法：术前对83例疑为腹外疝患者分别进行自动超声容积断层扫描及传统超声检查,通过UVAS的切面(横断面、矢状面、冠状面)以及传统超声的二维图像和彩色多普勒技术,对腹外疝的立体结构、疝环位置、疝囊、疝内容物及回纳途径进行观察,判断其的类型,并将诊断结果与术后诊断进行对照。结果：对于腹外疝不同分类的诊断,UVAS诊断腹壁切口疝和难复性腹股沟疝的符合率更高,传统超声检查诊断可复性腹股沟疝的符合率更高。结论：两种不同的检查方法比较,UVAS对腹壁切口疝和难复性腹股沟疝的诊断比传统超声检查更具优势。两种检查方法有效结合,将为临床明确诊断腹外疝提供最有效、最便捷的影像依据。
[Abstract]:The purpose of this paper is to study the value of traditional ultrasonography and automatic ultrasound volume tomography in the diagnosis of abdominal external hernia during perioperative period, and to compare the advantages of the two kinds of examinations in different classification of external abdominal hernia. The aim is to provide the most effective, the simplest and the quickest diagnostic basis for clinical imaging. Part one: to study the value of traditional ultrasonography in evaluation of inguinal hernia before and after operation. Methods: 32 patients with inguinal hernia were examined by two-dimensional ultrasound before and after operation. The position of the internal ring, the diameter of the inguinal tube, the size and contents of the hernia sac were observed before operation and the types of inguinal hernia were classified, and the position, size, morphology and fusion of the patch with the surrounding tissues were observed after operation. Results: among 32 cases, 20 cases had indirect hernia 4 cases had direct hernia and 3 cases had femoral hernia. Ultrasonic examination within one month after operation showed that 28 cases had normal biological patch, 2 cases had no other abnormal echo and 1 case had recurrent hernia and 1 case had deformation. Conclusion: before inguinal hernia operation, ultrasonic examination can provide the detailed reference data of inguinal hernia morphology for clinicians, and provide important objective basis for clinicians to select biological patch suitable for individual patients. After inguinal hernia operation, ultrasonic examination can observe the morphology, location and other complications of biological patch. Part two: to study the application value of automatic ultrasound volume tomography in classification diagnosis of abdominal external hernia. Methods: 62 cases of suspected external abdominal hernia were examined by automatic ultrasound volume tomography (AUVs) before operation. The three-dimensional structure, position of hernia ring and hernia sac were examined by any section (cross section, sagittal plane, coronal plane) of AUVS. The hernia contents and resuscitation pathway were observed and the types of external abdominal hernia were diagnosed and compared with postoperative diagnosis. Results: in the classification of external abdominal hernia, the diagnostic accuracy of AUVS for incisional hernia of abdominal wall was higher than that of AUVS for refractory hernia of inguinal hernia, which was higher than that of AUVS for the diagnosis of reducible inguinal hernia. Conclusion the coronal images of tissues displayed by the 10% AUVS can provide the three-dimensional and objective imaging data for the clinicians. In the diagnosis classification of external abdominal hernia, AUVS can provide definite imaging support for the diagnosis of incisional hernia and inguinal hernia. Part three: through clinical research, the advantages of automatic ultrasound volume tomography and traditional ultrasound in the classification diagnosis of external abdominal hernia are compared. Methods: 83 patients with suspected external abdominal hernia were examined by automatic volume tomography and traditional ultrasound respectively. The UVAS section (transverse, sagittal, coronal) and the color Doppler technique of traditional ultrasound were used. The stereoscopic structure, location of herniation ring, hernia sac, hernia contents and resuscitation pathway of external abdominal hernia were observed, the types of hernia were judged, and the diagnostic results were compared with postoperative diagnosis. Results: the coincidence rate of UVAS in the diagnosis of incisional hernia and refractory inguinal hernia was higher than that of traditional ultrasonography. Conclusion: UVAS is superior to traditional ultrasound in the diagnosis of incisional hernia and inguinal hernia. The effective combination of the two methods will provide the most effective and convenient imaging basis for the clinical diagnosis of abdominal external hernia.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R445.1;R816.5;R656.2

【相似文献】