不同病理类型阑尾炎超声直接征象的对比分析  

Comparative analysis of direct ultrasonographic signs of appendicitis with different pathological types

作　　者：蔡少雨[1] 韩咏峰 李锐锋[1] 刘珊珊[1] 古佩巧 丘焰光 严冬梅[1] 黄颖林[1] CAI Shao-yu;HAN Yong-feng;LI Rui-feng(Department of Ultrasound,Guangdong Foshan Gaoming District People＇s Hospital,Foshan 528500,China)

机构地区：[1]广东省佛山市高明区人民医院超声诊断中心,528500

出　　处：《中国实用医药》2018年第33期17-20,共4页China Practical Medicine

基　　金：2015年佛山市医学类科技攻关项目(项目编号:2015AB001014)

摘　　要：目的通过回顾性对比分析不同病理类型阑尾炎超声直接征象声像图特征,探讨超声直接征象在阑尾炎分型中的诊断价值。方法对超声检查并得到手术及病理证实的急性单纯性阑尾炎30例、慢性阑尾炎急性发作57例、急性化脓性阑尾炎498例与坏疽性阑尾炎49例的超声直接征象进行回顾性对比分析。结果阑尾直径≥6 mm在急性单纯性阑尾炎与急性化脓性阑尾炎患者、急性单纯性阑尾炎与坏疽性阑尾炎患者、慢性阑尾炎急性发作与急性化脓性阑尾炎患者、慢性阑尾炎急性发作与坏疽性阑尾炎患者之间比较差异具有统计学意义(χ~2=92.57、18.70、99.84、17.41, P<0.05)。阑尾壁层次不清在急性单纯性阑尾炎与坏疽性阑尾炎患者、慢性阑尾炎急性发作与坏疽性阑尾炎患者、急性化脓性阑尾炎与坏疽性阑尾炎患者之间比较差异具有统计学意义(χ~2=18.70、49.06、90.20, P<0.05)。阑尾壁连续性中断在急性单纯性阑尾炎与坏疽性阑尾炎患者、慢性阑尾炎急性发作与坏疽性阑尾炎患者、急性化脓性阑尾炎与坏疽性阑尾炎患者之间比较差异具有统计学意义(χ~2=11.34、20.34、68.68, P<0.05)。节段性肿大在急性单纯性阑尾炎与慢性阑尾炎急性发作患者、慢性阑尾炎急性发作与急性化脓性阑尾炎患者、慢性阑尾炎急性发作与坏疽性阑尾炎患者之间比较差异具有统计学意义(χ~2=9.54、83.37、15.02, P<0.05)。结论大部分超声直接征象已经足够为鉴别不同病理类型阑尾炎提供重要依据,大部分不同类型的阑尾炎均有典型的超声直接征象。Objective To explore the diagnostic value of direct ultrasound imaging in appendicitis classification by retrospective analysis of ultrasonographic features of appendicitis in different pathological types. Methods The direct ultrasonographic signs of acute simple appendicitis（30 cases）, acute attack of chronic appendicitis（57 cases）, acute suppurative appendicitis（498 cases） and gangrenous appendicitis（49 cases） confirmed by operation and pathology were retrospectively analyzed. Results There was statistically significant difference in appendix diameter ≥6 mm between patients with acute simple appendicitis and acute suppurative appendicitis, acute simple appendicitis and gangrenous appendicitis, acute attack of chronic appendicitis and acute suppurative appendicitis, acute attack of chronic appendicitis and gangrenous appendicitis（χ^2=92.57, 18.70, 99.84, 17.41, P〈0.05）. There were significant differences in appendix wall ambiguity between patients with acute simple appendicitis and gangrenous appendicitis, acute attack of chronic appendicitis and gangrenous appendicitis, acute suppurative appendicitis and gangrenous appendicitis（χ^2=11.34, 20.34, 68.68, P〈0.05）. There were significant differences in segmental enlargement between patients with acute simple appendicitis and acute attack of chronic appendicitis, acute attack of chronic appendicitis and acute suppurative appendicitis, acute attack of chronic appendicitis and gangrenous appendicitis（χ^2=9.54, 83.37, 15.02, P〈0.05）. Conclusion Most of the direct ultrasonographic signs are sufficient to provide an important basis for differentiating different pathological types of appendicitis. Most types of appendicitis have typical direct ultrasonographic signs.

关 键 词：阑尾炎 超声诊断 直接征象 对比分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R574.61[医药卫生—诊断学]