急性阑尾炎的超声征象与病理分型之间的关系研究  

Relationship between Ultrasound Features and Pathological Type of Acute Appendicitis

作　　者：吴芳[1] 崔凤荣[1] 芦桂林[1] 马婷[1] 康东[1] 郭坤霞[1] 姚兰辉[2] 

机构地区：[1]石河子大学医学院第一附属医院功能科,新疆石河子市832000 [2]新疆医科大学第一附属医院超声科,新疆乌鲁木齐市

出　　处：《中国全科医学》2013年第33期3998-4000,共3页Chinese General Practice

摘　　要：目的探讨急性阑尾炎的超声征象与病理分型之间的关系。方法选取2010年10月—2012年9月经我院外科手术及病理证实的急性阑尾炎患者109例,观察阑尾的超声征象:阑尾大小、黏膜下层厚度、腔内粪石、阑尾周围积液及肠系膜区淋巴结,并与阑尾的病理分型(单纯性阑尾炎、化脓性阑尾炎、坏疽性阑尾炎)对照分析,应用受试者工作特征(ROC)曲线评估各项指标诊断急性阑尾炎的临床价值。结果单纯性阑尾炎组、化脓性阑尾炎组及坏疽性阑尾炎组的阑尾短径、黏膜下层厚度比较,差异均有统计学意义(P<0.05);其中阑尾短径组间两两比较,差异均有统计学意义(P<0.05);阑尾黏膜下层厚度,单纯性阑尾炎组较化脓性阑尾炎组和坏疽性阑尾炎组均减小(P<0.05),而坏疽性阑尾炎组与化脓性阑尾炎组比较差异无统计学意义(P>0.05)。3组间阑尾长径及有无腔内粪石、阑尾周围积液、淋巴结比较,差异均无统计学意义(P>0.05)。阑尾长径、阑尾短径、黏膜下层厚度诊断急性阑尾炎的ROC曲线下面积分别为0.632〔95%CI(0.459,0.804),P=0.103〕、0.768〔95%CI(0.647,0.888),P=0.001〕、0.785〔95%CI(0.699,0.871),P=0.000〕。结论阑尾的短径增大、黏膜下层增厚形成靶环征象是鉴别急性阑尾炎的有意义超声征象,综合分析各超声征象有助于各病理分型的鉴别诊断,为临床制定正确的治疗方案提供依据。Objective To investigate the relationship between ultrasound features and pathological type of acute ap- pendicitis. Methods 109 patients with acute appendicitis confirmed by surgery and pathology in our hospital from October 2010 to September 2012 were selected. The ultrasound features of acute appendicitis were analyzed, including the size, submucosa thickness of the appendix, fecal stones, effusion around the appendix and mesenteric lymph node. The features were comparative- ly analyzed with the pathological type of appendicitis, including simple appendicitis, suppurative appendicitis and gangrenous ap- pendicitis. ROC curve was used to evaluate the diagnostic value of ultrasound features of appendicitis. Results Short diameter and submucosa thickness of the appendix showed statistically significant differences between simple appendicitis, suppurative appendi- citis and gangrenous appendicitis. The difference was also statistically significant when compared between two groups separately （P 〈 0. 05 ） . The simple appendicitis group had significantly thinner submucosa compared with the other two groups （ P 〈 0.05 ）, and the submucosa thickness between the suppurative appendicitis group and gangrenous group showed no statistically sig- nificant difference （P 〉0. 05） . Long diameter and fecal stones the cavity, effusion around the appendix and mesenteric lymph node between the three groups showed no statistically significant difference （ P 〉 0. 05 ） . The area under the ROC curve （ area under the curve, AUC） of appendix long diameter, short diameter and submucosa thickness were separately 0. 632 [ 95% C! （0.459, 0.804）, P=0.1033, 0.768 [95%C1 （0.647, 0.888）, P=0.001], 0.785 [95%C1 （0.699, 0.871）, P= 0. 000 ] . Conclusion Increasing of short diameter of the appendix and increasing of submucosa thickness forming a target sign are ultrasound features with significance. Comprehensive analysis of different ultrasound signs is helpful to the diagnosis and treat- ment of different

关 键 词：阑尾炎 超声检查 

分 类 号：R574.61[医药卫生—消化系统]