多层螺旋CT与超声检查诊断急诊上消化道穿孔的临床价值分析

李香芝

doi:10.3969/j.issn.1671-038X.2017.04.16

多层螺旋CT与超声检查诊断急诊上消化道穿孔的临床价值分析

李香芝^,

- 宁海县中医医院放射科, 浙江宁海 315600

详细信息

作者简介:
李香芝,女,学士,主治医师,研究方向:肺部玻璃结节(或亚实性)病变,急腹症影像

通讯作者: 李香芝,E-mail:lixiangzhi790@163.com

中图分类号: R816.5;R445.1

收稿日期: 2016-02-03

Clinical value of multi slice spiral CT and ultrasonography in the diagnosis of emergency upper gastrointestinal perforation

LI Xiang-zhi^,

- Department of Radiology, Ninghai County Hospital of Traditional Chinese Medicine, Ninghai 315600, China

More Information

Corresponding author: LI Xiang-zhi, E-mail: lixiangzhi790@163.com

Received Date: 03 February 2016

摘要

摘要: [目的]对比多层螺旋CT与超声检查诊断急诊上消化道穿孔的临床价值。[方法]采用回顾性研究方法，选择2012年2月~2016年8月在我院急诊诊治的上消化道穿孔患者80例作为研究对象，所有患者都给予多层螺旋CT与超声检查，记录影像学特征，对比检出率。[结果]超声检出上消化道穿孔71例，检出率为88.8%，CT检出上消化道穿孔79例，检出率为98.8%，CT对于上消化道穿孔的检出率明显高于超声（P<0.05）。超声诊断为少量腹腔积液60例，中量腹腔积液15例，大量腹腔积液5例；大量气腹50例，少量气腹22例，无气腹8例。CT诊断为大量气腹50例，少量气腹26例，无气腹4例；腹腔少量积液60例，中量腹腔积液16例，大量腹腔积液4例。[结论]上消化道穿孔是严重的急腹症，多层螺旋CT的应用可观察到超声不能发现的腹腔内积液和游离气体，从而为上消化道穿孔提供了更准确的影像学检查手段，有很好的应用价值。
- 多层螺旋CT /
- 超声 /
- 上消化道穿孔 /
- 腹水 /
- 积液
Abstract: [Objective] To compare the clinical values of multi slice spiral CT and ultrasonography in the diagnosis of emergency upper gastrointestinal perforation.[Methods] A retrospective study was conducted to select 80 patients with upper gastrointestinal perforation in our hospital from 2012-02 to 2016-08, all patients were received multi-slice spiral CT and ultrasonography diagnosis, recorded the imaging features, the detection rate of two ways were contrasted.[Results] Seventy-one upper digestive tract perforation patients were detected by ultrasound, the detection rate was 88.8%.And 79 upper digestive tract perforation patients were detected by CT, the detection rate was 98.8%, the detection rate of CT for the upper digestive tract perforation was significantly higher than that of ultrasound(P<0.05).Ultrasound diagnosis of 60 patients of small amount of ascites, 15 patients were in the amount of ascites, 5 patients were massive ascites;the large number of pneumoperitoneum were 55 patients, 22 patients were small gasless pneumoperitoneum, 8 patients were no gasless pneumoperitoneum.CT diagnosed small amount of ascites was 60 patients, 16 patients was ascites, 4 patients was large amount of ascites.The large number of pneumoperitoneum was 50 patients, small amount of pneumoperitoneum was 26 patients, and 4 patients were without pneumoperitoneum.[Conclusion] Upper gastrointestinal perforation is a severe acute abdomen.The multi-slice spiral CT can be observed in the application of ultrasound can not be found by free intraperitoneal gas and peritoneal effusion.It can provide more accurate imaging means for the upper digestive tract perforation and has good application value.
- multi slice spiral CT /
- ultrasound /
- upper gastrointestinal perforatio /
- ascites /
- effusion

HTML全文

参考文献(22)

[1]	赵霞, 马艳红, 王宁.MSCT在上消化道穿孔定位诊断中的应用价值[J].中国中西医结合影像学杂志, 2016, 14(5):581-582.
[2]	Chen Y W, Wang H C, Gao L H, et al.Osteoclastogenesis in local alveolar bone in early decortication-facilitated orthodontic tooth movement[J].PLoS One, 2016, 11(4):3937-3743.
[3]	李萍, 王璐, 马平.超声诊断上消化道穿孔两例病例报告及文献复习[J].新疆医学, 2015, 45(8):1127, 1130.
[4]	Chevalier É, Philip-Alliez C, Le Gall M.Alveolar bone thickness in a point area:how to avoid periodontal failures in front of upper incisors[J].Orthod Fr, 2016, 87(1):39-48.
[5]	刘启平, 陈红燕, 龚新环, 等.超声检查在消化道穿孔中的诊断价值[J].上海医学影像, 2012, 21(2):124-126.
[6]	Chua E S, Felicita A S.The orthodontic extraction of permanent molars:a literature review[J].Aust Orthod J, 2015, 31(1):69-77.
[7]	孙萍萍.急性消化道穿孔的超声诊断[J].齐齐哈尔医学院学报, 2014, 35(8):1177-1178.
[8]	Yang C, Zhang Y, Zhang Y, et al.Three-dimensional quantification of orthodontic root resorption with time-lapsed imaging of micro-computed tomography in a rodent model[J].J Xray Sci Technol, 2015, 23(5):617-626.
[9]	Chandhoke T K, Nanda R, Uribe F A.Clinical applications of predictable force systems, part 1:One-couple and two-couple systems[J].J Clin Orthod, 2015, 49(3):173-184.
[10]	陈彩女.超声检查在急性上消化道穿孔诊断中的应用价值分析[J].中国初级卫生保健, 2012, 26(11):107-108.
[11]	Moon W, Wu K W, MacGinnis M, et al.The efficacy of maxillary protraction protocols with the micro-implant-assisted rapid palatal expander(MARPE) and the novel N2 mini-implant-a finite element study[J].Prog Orthod, 2015, 16(16):601-609.
[12]	Agarwal S, Shah N, Yadav S, et al.Mandibular arch retraction with retromolar skeletal anchorage in a Class Ⅲ open-bite patient[J].J Clin Orthod, 2014, 48(12):775-782.
[13]	钱向宇, 冯宪超, 潘恒.多排螺旋CT在不典型消化道穿孔诊断中的应用[J].浙江临床医学, 2014, 13(6):977-978.
[14]	Vieira G M, Chaves S B, Ferreira V M, et al.The effect of simvastatin on relapse of tooth movement and bone mineral density in rats measured by a new method using microtomography[J].Acta Cir Bras, 2015, 30(5):319-327.
[15]	马骏.探讨X线腹部立位平片、多层螺旋CT在上消化道穿孔中的临床应用价值[J].中国实用医药, 2016, 11(23):108-109.
[16]	Tadinada A, Mahdian M, Vishwanath M, et al.Evaluation of alveolar bone dimensions in unilateral palatally impacted canine:a cone-beam computed tomographic analyses[J].Eur J Orthod, 2015, 37(6):596-602.
[17]	招桂炎.多层螺旋CT局限性小气泡征在消化道穿孔中的定位诊断价值探讨[J].现代医用影像学, 2016, 25(4):674-675.
[18]	Ma Z, Xu G, Yang C, et al.Efficacy of the technique of piezoelectric corticotomy for orthodontic traction of impacted mandibular third molars[J].Br J Oral Maxillofac Surg, 2015, 53(4):326-331.
[19]	安玉怀, 杨青.腹腔镜、胃镜、腹部CT三维重建三者联合对急性上消化道穿孔诊治的临床体会[J].世界最新医学信息文摘(连续型电子期刊), 2016, 16(9):64-64.
[20]	Fernandes H O, Santos L B, Firoozmand L M.Shear bond strength of an orthodontic self-etching adhesive after intracoronary bleaching[J].Orthod Craniofac Res, 2015, 18(2):117-124.
[21]	郭荣学.上消化道穿孔80例超声诊断分析[J].中国医药导报, 2011, 8(3):166-167.
[22]	Yáñez-Vico R M, Iglesias-Linares A, Ballesta-Mudarra S, et al.Short-term effect of removal of fixed orthodontic appliances on gingival health and subgingival microbiota:a prospective cohort study[J].Acta Odontol Scand, 2015, 73(7):496-502.