绞窄性肠梗阻患者诊断指标的多因素分析  

Multivariate analysis of diagnostic indicators of strangulated intestinal obstruction

作　　者：胡孝海[1] 田进[1] 

机构地区：[1]广东省深圳市坪山新区人民医院急诊科,广东深圳518000

出　　处：《胃肠病学和肝病学杂志》2015年第3期298-300,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探索绞窄性肠梗阻的诊断指标。方法回顾性分析2009年1月-2013年1月收治的148例行手术治疗的肠梗阻患者的临床资料,其中绞窄性肠梗阻(绞窄组)98例,非绞窄性肠梗阻(非绞窄组)50例。结果腹膜刺激征及肠壁不强化或弱强化是绞窄性肠梗阻的主要预测指标(OR=4.255,P<0.001;OR=4.743,P<0.001);发热及腹水预测绞窄的OR值分别为3.051、2.998(P=0.021,P=0.003)。有腹部手术史的患者更易发生非绞窄性肠梗阻(OR=0.064,P<0.001)。结论预测绞窄性肠梗阻的主要指标是腹膜刺激征和肠壁不强化或弱强化。但是发热、腹水、腹部手术史也有助于判断是否绞窄。Objective To investigate the diagnostic indicators of strangulated intestinal obstruction. Methods The clinical data of 148 patients with strangulated intestinal obstruction who underwent surgery from Jan. 2009 to Jan. 2013 were reviewed. They were divided into the strangulated group （98 cases of strangulated intestinal obstruction） and the non-strangulated group （50 cases of non-strangulated intestinal obstruction）. Results The most significant independent predictors of strangulated intestinal obstruction were the signs of peritoneal irritation and the CT finding of reduced wall enhancement （OR = 4. 255, P 〈 0. 001; OR = 4. 743, P 〈 0. 001 ）. The OR of fever and ascites^were 3. 051 and 2. 998, respectively （P =0. 021, P =0. 003）. The patients with a history of previous abdominal operation were apt to develope non-strangulated intestinal obstruction （ OR = 0. 064, P 〈 0. 001 ）. Conclusion The signs of peritoneal irrita- tion and the CT finding of reduced wall enhancement were the most significant indicators. But fever, ascites and history of previous abdominal operation are help to determine whether the intestine is strangulated.

关 键 词：肠梗阻 诊断 分析 

分 类 号：R574.2[医药卫生—消化系统]