螺旋CT检查在腹部创伤诊断中的应用价值  

Clinical value of spiral CT in the diagnosis of abdominal trauma

作　　者：李宏斌[1] 

机构地区：[1]台州市博爱医院放射科,浙江省台州318050

出　　处：《中国基层医药》2017年第22期3482-3485,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 分析螺旋CT在腹部创伤诊断中的临床应用价值,为临床诊治提供参考.方法 选择腹部创伤患者98例,分别于术前行腹部彩超及螺旋CT检查.参照术中情况,对术前彩超及螺旋CT检查结果进行比较,比较内容包括诊断灵敏度、诊断特异度以及诊断准确率.结果 螺旋CT诊断阳性81例,阴性17例,螺旋CT诊断阳性率82.65%.术中探查证实阳性诊断结果中1例为假阳性,阴性诊断结果中3例为假阴性.螺旋CT诊断灵敏度为96.39%,特异度为93.33%,准确率95.92%.彩超检查诊断阳性77例,阴性21例,彩超检查诊断阳性率78.57%.术中探查证实阳性诊断结果中4例为假阳性,阴性诊断结果中10例为假阴性.彩超检查灵敏度为87.95%,特异度为73.33%,准确率85.71%.螺旋CT检查灵敏度高于彩超检查,差异有统计学意义（χ2=5.081,P〈0.05）,螺旋CT检查特异度高于彩超检查,差异有统计学意义（χ2=6.491,P〈0.05）,螺旋CT检查准确率高于彩超检查,差异有统计学意义（χ2=6.667,P〈0.05）.结论 螺旋CT检查在腹部创伤诊断中较腹部彩超具有更高的准确率,有助于医生更好地明确受损的脏器及程度,进而采取相应的治疗措施,降低患者死亡的风险.Objective To analyze the value of spiral CT in the diagnosis of abdominal trauma, thus to provide reference for clinical diagnosis and treatment. Methods 98 patients with abdominal trauma were selected. Abdominal ultrasonography and spiral CT were given before operation and the results were compared, including sensitivity,specificity and accuracy according to intraoperative situations. Results According to CT, there were 81 positive cases and 17 negative cases, and the positive diagnosis rate was 82. 65%. The intraoperative exploration showed that there was 1 false positive case and 3 false negative cases. The sensitivity of spiral CT was 96. 39%, specificity was 93. 33%,and accuracy was 95. 92%. According to abdominal ultrasonography,there were 77 positive cases and 21 negative cases,and the positive diagnosis rate was 78. 57%. The intraoperative exploration showed that there was 4 false positive cases and 10 false negative cases. The sensitivity of spiral CT was 87. 95%,specificity was 73. 33%,and accuracy was 85. 71%. The sensitivity of CT was higher than ultrasonography（χ2 =5. 081,P〈0. 05）, the specificity of CT was higher than ultrasonography（χ2 =6. 491,P〈0. 05）,the accuracy of CT was higher than ultrasonography（χ2 =6. 667,P〈0. 05）. Conclusion The diagnosis accuracy of spiral CT is higher for abdominal trauma,and it is more helpful for doctors to definite the damaged organ and degree to adopt corresponding treatment methods,and the risk of death can be decreased.

关 键 词：腹部损伤 体层摄影术 螺旋计算机 超声检查 多普勒 彩色 

分 类 号：R656[医药卫生—外科学] R816.5[医药卫生—临床医学]