影像学检查在急性胃十二指肠穿孔诊断中的价值  

Diagnostic value of imaging examination in acute gastroduodenal perforation

作　　者：王久惠[1] 李舸[1] 谢佳航[1] 贾红[1] 王浩[1] 

机构地区：[1]四川省肿瘤医院急诊科,四川成都610041

出　　处：《现代医药卫生》2011年第18期2752-2754,共3页Journal of Modern Medicine & Health

摘　　要：目的:探讨三种影像学检查在急性胃十二指肠穿孔中的诊断意义。方法:对我院收治的52例经手术和病理证实为急性胃十二指肠穿孔患者的影像学资料进行回顾性分析,比较腹部X线片、超声和CT 3种检查结果的敏感度。结果:3种影像学检查手段诊断急性胃十二指肠穿孔的准确率分别是:X线摄片67.31%、超声84.62%、多断计算机断层摄影术(multisice computed tomography,MSCT)91.67%。超声及MSCT的准确率均高于X线片(χ2=4.265和5.197,P均<0.05);MSCT的敏感性高于X线片,但差异无统计学意义(χ2=0.715,P>0.05)。在发病时间<6 h的病例中,各个方法的敏感性均有所下降,超声和MSCT的敏感性差异无统计学意义(χ2=0.267,P>0.05),但均高于X线片(χ2=4.207,P<0.05)、(χ2=4.669,P<0.05)。结论:对胃十二指肠穿孔的诊断,超声和CT两种影像学检查的准确率无明显差异,均优于X线片,但两者间差异不明显。Objective：To study the diagnostic value of abdominal plain film,ultrasonography（US） and multislice spiral CT（MSCT） in acute gastroduodenal perforation.Methods：We retrospectively analyzed the imaging data of 52 consecutive cases with gastroduodenal perforation confirmed by surgical pathology in our hospital during 2005-2009.The manifestations of the three approaches were studied to compare their sensitivity.Results：In all the cases of gastroduodenal perforation,the accurate rates of abdominal plain film,ultrasonography and multislice spiral CT were 67.31%,84.62% and 91.67% respectively.The diagnostic sensitivity of US and MSCT was higher than that of abdominal plain film（χ2=4.265 and 5.197,P=0.039 and 0.023）.The diagnostic sensitivity of MSCT was higher than that of US,but there was no significant difference between them（χ2=0.715,P=0.398）.In the cases of onset time6 h,the sensitivity of each approach was declined a little.There was no significant difference between the sensitivities of US and MSCT（χ2=0.267,P=0.605）,and both of them were higher than that of abdominal plain film（χ2=4.207,P=0.040;χ2=4.669,P=0.031）.Conclusion：There is no significant difference between the sensitivities of US and MSCT in diagnosis of gastroduodenal perforation,and both of them are superior to the abdominal plain film.

关 键 词：胃十二指肠 穿孔 诊断 X线片 超声 CT 

分 类 号：R5[医药卫生—内科学]