小肠梗阻CT表现对手术治疗的预测价值  

Value of CT findings in predicting the need for surgery in patients with small bowel obstruction

作　　者：苏伟[1] 刘磊[1] 庞闽厦[1] 王玉强[1] SU Wei LIU Lei PANG Minxia WANG Yuqiang(Department of CT, Shengli Oilfield Central Hospital, Dongying, Shandong Province 257034,Chin)

机构地区：[1]胜利油田中心医院CT检查科,山东东营257034

出　　处：《实用放射学杂志》2016年第10期1556-1558,1569,共4页Journal of Practical Radiology

摘　　要：目的：探讨小肠梗阻（SBO）CT 表现对手术治疗的预测价值。方法70例 SBO 患者按照治愈方式分为非手术治疗组与手术治疗组,回顾性比较2组间 CT 表现有无差异,分析有意义 CT 表现对于手术治疗的预测价值。结果70例 SBO 中,33例采用非手术治疗,37例采用手术治疗。移行带肠壁完全瘪陷、肠系膜水肿、腹水、肠系膜静脉淤血增粗、肠壁强化减低、肠系膜动脉和静脉强化减低出现的几率在手术治疗组显著高于非手术治疗组（P 〈0.05）,预测手术的比数比分别为10.56、5.13、4.72、5.45、5.77、3.02、6.59。而扩张肠管内径、肠壁厚度、环靶征、肠壁积气、肠系膜血管移位、聚集和扭曲出现的几率在2组间无统计学差异。结论SBO 多种 CT 表现对其手术治疗具有预测价值,可为 SBO 的治疗提供重要信息。Objective To investigate the value of CT findings in predicting the need for surgery in patients with small bowel obstruction （SBO）.Methods Seventy patients with SBO were classified into non-operation and surgery groups according to the clinical treatment.The CT findings were retrospectively compared between the two groups,and the predictive value for surgery of useful CT findings was analyzed.Results Thirty three of 70 patients were cured with non-operative treatment and other 37 with surgery.The incidences of complete collapse of transitional zone,mesenteric edema,ascites,engorgement of mesenteric veins,decreased enhancement of bowel wall,decreased enhancement of mesenteric arteries and veins in surgery group were statistically higher than those in non-operation group,with odds ratios for surgery of 10.56,5.13,4.72,5.45,5.77,3.02 and 6.59,respectively.The diameter of dilated bowel,bowel wall thickness,and the incidence of target sign,intestinal pneumatosis,displacement,convergence and tortuosity of mesenteric vasculatures were not statistically different between the two groups.Conclusion Multiple CT findings of SBO are useful to predict the need for surgery,and may provide important information for clinical management of SBO.

关 键 词：小肠梗阻 计算机体层成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R574.5[医药卫生—放射医学]