不同缺血程度的绞窄性肠梗阻超声表现：与手术病理对照  

Analysis of ultrasonic findings of strangulated obstruction with varied ischemic degrees:Comparison with surgical pathology

作　　者：黄春旺[1] 周立峰[1] 王满立[1] 甘科红[1] 王光霞[2] 

机构地区：[1]广东省医学科学院广东省人民医院超声科,广东广州510080 [2]天津市南开医院超声科,天津300100

出　　处：《中国介入影像与治疗学》2014年第3期157-160,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨不同缺血程度绞窄性肠梗阻的超声表现及临床意义。方法回顾性分析52例不同缺血程度绞窄性肠梗阻患者的声像图特征,并与手术、病理结果相对照。结果肠管缺血、但尚无坏死时,声像图特征包括肠壁增厚,呈低回声,横断面呈"面包圈征",黏膜皱襞水肿增厚,呈"珊瑚样"改变;8例肠壁间可见多个环状低回声,可呈"串珠样",血流信号为静脉血流频谱;13例腹腔积液,透声好。肠管缺血坏死时,声像图可见黏膜层与浆膜层呈"分离征"或"剥脱样"改变,局部管壁缺乏膨胀性,呈塌瘪征象;CDFI示局部肠壁间血流信号消失;12例腹腔积液,呈密集点状高回声群,动态观察短期内积液快速增多。结论超声可评价绞窄性肠梗阻所致不同程度肠管缺血,对临床诊断及治疗具有重要价值。Objective To observe ultrasonic findings of strangulated obstruction, and to assess clinical value of ultrasound for evaluation on strangulated obstruction with varied ischemic degrees. Methods Ultrasonic findings of 52 patients with strangulated obstruction confirmed by surgery were retrospectively analyzed, and the results were compared with surgical and pathological outcomes. Results Intestinal ischemia showed hypoecho of thickened bowel walls well as ＂doughnut＂ and ＂coral＂ signs, while sign of ＂beads＂ and displayed vein flow spectrum were observed in 8 patients, and homogenous and strong sound transmission were found in 13 patients with peritoneal effusion. Intestinal necrosis showed mucosa and serosa layer changes like ＂separation＂ and ＂strip＂, or part of bowel wall lacked expansibility, while CDFI could not detect signals of blood flow in bowel wall, and peritoneal effusion increased rapidly in a short time as dense and punctuate hypoecho in 12 cases. Conclusion Ultrasonography can evaluate strangulated obstruction with different extent of intestinal ischemia, therefore providing important information for clinical diagnosis and treatment.

关 键 词：肠梗阻 超声检查 缺血 坏死 

分 类 号：R574.2[医药卫生—消化系统] R445.1[医药卫生—内科学]