腹壁下动脉与多因素综合分析在超声鉴别诊断腹股沟疝中的对比研究  

Comparison and Analysis About Inferior Epigastric Artery and Multiple Factors in the Differential Diagnosis of Inguinal Hernia by Ultrasound

作　　者：罗玉群[1] 岳文胜[1] 顾鹏[1] 曹礼庭[1] 张宁[1] 袁顺娴[1] 王萍[1] 

机构地区：[1]川北医学院附属医院超声科,四川省南充市637000

出　　处：《中国超声医学杂志》2013年第9期819-822,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的对比研究腹壁下动脉与多因素综合分析在超声鉴别诊断腹股沟斜疝及直疝中的价值。方法以经我院超声诊断为腹股沟疝并进行疝修补术患者75例,共85侧腹股沟为研究对象。超声观察并记录每侧疝的大小、形态及长轴走行,疝环位置(即腹壁缺损处),疝块与精索或圆韧带、腹壁下动脉的关系。多因素组以疝的形态及长轴走行、疝环位置、疝块与精索或圆韧带的关系作为鉴别腹股沟斜疝与直疝的标志;腹壁下动脉组(IEA组)以疝块与腹壁下动脉的关系作为鉴别标志。将2组鉴别诊断结果与术后诊断对比,并行组间对比。结果术后诊断腹股沟疝共85侧,其中斜疝66侧,直疝18侧,斜疝合并直疝1侧。85侧腹股沟包块定性诊断为腹股沟疝,定性诊断准确率100%,多因素组鉴别诊断准确率为斜疝97%(64/66)、直疝89%(16/18)、同侧斜疝合并直疝100%(1/1);IEA组鉴别诊断准确率为斜疝90%(60/66)、直疝76%(12/18)、同侧斜疝合并直疝0(0/1)。结论高频超声能显示疝的形态及长轴走行、疝环位置、疝块与精索或圆韧带的关系,作为多因素鉴别依据较常规单一IEA鉴别具有更强的可操作性和更高的准确性。Objective To compare and analyze the value of multiple factors and inferior epigastric artery （lEA） in the differential diagnosis of indirect inguinal hernia （IIH） and direct inguinal hernia （DIH）by ultrasound. Methods A total of 75 patients with 85 inguinal hernias diagnosed by ultrasound, who had inguinal hernia repairs later, were included in this study. Ultrasonic visualization of the hernia shape and long axis, the place of hernia ring, and the spermatic cord or the round ligament were taken as the anatomical landmarks of the multiple factors group for differentia- tion between IIH and DIH. The inferior epigastric artery （IEA）, as the anatomical landmarks of the lEA group, was detected and recorded too. The two groups＇ ultrasonographic findings of the type of inguinal hernia were compared with the surgical findings. Diagnostic accuracy of the two groups was contrast with each other. Results 85 inguinal hernias were diagnosed after surgery, in which IIH were in 66 cases, DIH in 18 cases, IIH combined with DIH in same right groin in 1 case. All 85 inguinal hernias were diagnosed by ultrasonography with the accuracy rate of 100%. In the multiple factors group, the accuracy rate of ultrasonogaphy in differentiating IIH was 97 % （64/66）, for DIH 89 % （16/ 18）, and for IIH with DIH 100%0（1/1）. In the IEA group, the accuracy rate in differentiating IIH was 90%（60/66）, for DIH 76 % （12/18）, In the one IIH combined with DIH case, hernia type was incorrectly differentiated. Conclusions The hernia shape and long axis, the place of hernia ring, and the spermatic cord or the round ligament which could be detected clearly by the high-frequency ultrasound could serve as landmarks for differentiating IIH and DIH with greater accuracy and practice than the IEA.

关 键 词：腹股沟疝 超声鉴别 多因素综合分析 腹壁下动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学] R656.21[医药卫生—诊断学]