| 摘要: |
| 目的:建立粘连性肠梗阻的超声评分系统，并探讨其临床应用价值。方法:将肠管缺血性损害、肠管出现绞窄性改变、合并腹内疝、肠扭转和肠套叠等并发症、腹腔血性积液、肠管扩张程度、肠壁增厚伴肠腔缩窄，这6 项指标纳入超声评分系统，对124 例粘连性肠梗阻病例进行评分，并将评分结果与CT 及手术结果进行统计学比较。结果:124 例粘连性肠梗阻病例得分结果如下:最高分16 分，最低分4 分，平均(10±2.7)分，与手术结果对照，超声评分分值越高，严重程度越重，危险度越高。124 例粘连性肠梗阻中，超声与CT 对肠管缺血性损害的诊断符合率分别为80% 和70%，差异无统计学意义(P >0.05)；超声与CT 对肠管出现绞窄性改变的诊断符合率分别为95.1% 和86.4%，对腹内疝、肠扭转或肠套叠的诊断符合率分别为46.7% 和82.2%，差异均有统计学意义(P <0.01)；超声与CT 对腹腔血性积液的诊断符合率分别为46.7% 和60%，对肠管扩张程度的诊断符合率均为100%，对肠壁增厚伴肠腔缩窄的诊断符合率分别为72.1% 和69.8%，差异均无统计学意义(P >0.05)。结论:粘连性肠梗阻的超声评分系统可以帮助临床对粘连性肠梗阻的严重程度进行评估，可为临床医师制订治疗方案提供影像依据，从而有利于提高治愈率、减少死亡率。 |
| 关键词: 超声 肠梗阻 肠粘连 评分 |
| DOI：10.3969/j.issn.1007-6948.2020.03.031 |
| 投稿时间：2020-01-11 |
| 基金项目:津门医学英才，天津市卫生计生行业高层次人才选拔培养工程(2018.10-2021.9) |
|
| The Value of Ultrasonic Scoring System in Evaluating the Severity of Adhesive Intestinal Obstruction |
| LILiang,WANG Guang-xia,CUI Yun-feng |
| Department of Ultrasound, Tianjin Nankai Hospital, Tianjin (300100),China |
| Abstract: |
| Objective To establish the ultrasonic scoring system for adhesive intestinal obstruction (AIO)and to discuss the clinical value of ultrasonic scoring system. Methods Six indicators which including intestinal ischemic damage, narrow changes in intestinal, internal hernia, volvulus or intussusception, celiac effusion, intestinal dilatation, intestinal wall thickening with intestinal cavity narrowing were incorporated into the scoring system. 124 cases of AIO were scored by US and the results were statistically compared with the results of CT and surgery. Results The scores of 124 cases of AIO were as follows: the highest score was 16 points,the lowest score was 4 points and the average score was (10±2.7) points. Compared with the results of surgery,the higher the ultrasonic score was, the greater the severity as well as the higher the risk simultaneously. In 124 cases of AIO, the diagnostic coincidence rates of US and CT for intestinal ischemic damage were 80% and 70% respectively, with no statistically significant difference (P >0.05). The diagnostic coincidence rates of US and CT for narrow changes in intestine were 95.1% and 86.4% respectively, with statistically significant differences(P <0.05).The diagnostic coincidence rates of US and CT for internal hernia, volvulus or intussusception were 46.7% and 82.2% respectively, with statistically significant differences (P <0.01). The diagnostic coincidence rates of US and CT for celiac effusion were 46.7% and 60% respectively, with no statistically significant difference (P >0 . 05 ). There was no significant difference in the diagnostic coincidence rate of the degree of intestinal dilatation between ultrasound and CT (P >0.05). The diagnostic coincidence rates of US and CT for intestinal wall thickening with intestinal cavity narrowing were 72.1% and 69.8% respectively, with no statistically signi?cant difference (P>0.05). Conclusion The ultrasonic scoring system can help to evaluate the severity of AIO and provide the imaging basis for the clinician to formulate the treatment plan, so as to improve the cure rate and reduce the death rate. |
| Key words: Ultrasonography intestinal obstruction intestinal adhesion scoring |
