摘要
目的 探究急性肠梗阻的临床特点及 64 排螺旋CT(MSCT)诊断价值.方法 选取我院 2022年 11 月至 2023 年 11月收治的 74 例首诊疑似急性肠梗阻患者资料,所有接受X线片及MSCT检查.以最终诊断为标准,比较 2 种检查方式对急性肠梗阻部位、类型、病因及整体诊断效能.比较急性肠梗阻阴性及阳性患者临床特点差异.结果 74 例疑似急性肠梗阻患者最终诊断阳性 61 例,阴性 13 例;最终诊断为急性肠梗阻的患者均出现腹痛、腹胀、恶心及停止排气、排便的症状,其中 7 例出现发热,47 例有腹部压痛,肠鸣音包括亢进 37例、减弱 22 例、消失 2 例;MSCT诊断急性肠梗阻的灵敏度和准确度均高于X线片(P<0.05),不同方法诊断急性肠梗阻的特异度差异无统计学意义(P＞0.05);不同方法诊断高位急性肠梗阻准确率差异无统计学意义(P＞0.05),MSCT对低位急性肠梗阻诊断准确率高于X线片(P<0.05);不同方法诊断动力性、机械性急性肠梗阻准确率差异无统计学意义(P＞0.05),MSCT对绞窄性急性肠梗阻诊断准确率高于X线片(P<0.05);不同检查方法对急性肠梗阻病因诊断准确率比较差异无统计学意义(P＞0.05).结论 急性肠梗阻患者临床除腹痛、腹胀、恶心等常规表现,还可表现为发热、腹部压痛及肠鸣音异常改变,使用 64 排MSCT可获得较高诊断满意效果.
Abstract
Objective To investigate the clinical features of acute intestinal obstruction and the diagnostic value of 64-slice spiral CT(MSCT).Methods Data of 74 patients with first diagnosis of suspected acute ileus admitted to our hospital from November 2022 to November 2023 were selected,all of whom received X-ray and MSCT examination.Based on the final diagnosis,the diagnostic efficacy of the two methods on the site,type,etiology,and overall diagnosis of acute ileus were compared.The clinical characteristics of negative and positive patients with acute intestinal obstruction were compared.Results Of 74 suspected patients with acute ileus,61 were positive and 13 were negative.All patients diagnosed with acute ileus had symptoms of abdominal pain,distension,nausea,and cessation of exhaust and defecation.Seven cases had a fever,47 cases had abdominal tenderness,and intestinal sounds were hyperactive in 37 cases,attenuated in 22 cases,and disappeared in 2 cases.The sensitivity and accuracy of MSCT in the diagnosis of acute ileus were higher than that of X-ray(P<0.05),and the specificity of different methods in the diagnosis of acute ileus had no significant difference(P＞0.05).There was no significant difference in the diagnostic accuracy of high acute ileus among different methods(P＞0.05),and the diagnostic accuracy of MSCT for low acute ileus was higher than that of X-ray(P<0.05).There was no significant difference in the diagnostic accuracy of dynamic and mechanical acute ileus(P＞0.05).The diagnostic accuracy of MSCT for strangulation acute ileus was higher than that of X-ray(P<0.05).There was no significant difference in diagnostic accuracy of etiology of acute ileus among different examination methods(P＞0.05).Conclusion In addition to abdominal pain,abdominal distension,and nausea,acute ileus patients can also present with fever,abdominal tenderness,and abnormal bowel sounds.64-row MSCT can obtain satisfactory results in diagnosis.
维普
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