不同体位CT检查对腹壁切口疝 容积评估的影响  

Effects of CT examination in different body positions on the evaluation of abdominal incisional hernia volume

作　　者：侯泽辉 江志鹏[1] 李雯莉[2] 刘伟[1] 李英儒[1] 周太成[1] 甘文昌[1] 陈双[1] Hou Zehui;Jiang Zhipeng;Li Wenli;Liu Wei;Li Yingru;Zhou Taicheng;Gan Wenchang;Chen Shuang(Department of Gastrointestinal and Hernia Surgery,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,National Key Clinical Specialized Department,the Sixth Affiliated Hospital of Sun Yat sen University,Guangzhou 510655,China;Department of Radiology,the Sixth Affiliated Hospital of Sun Yat sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院胃肠、疝和腹壁外科广东省结直肠盆底疾病研究重点实验室国家重点临床专科,广州510655 [2]中山大学附属第六医院放射影像科,广州510655

出　　处：《中华消化外科杂志》2019年第11期1075-1079,共5页Chinese Journal of Digestive Surgery

基　　金：广东省科技计划项目(2017A020215036);中山大学附属第六医院人才引进科研启动经费资助项目(P20150217201802102)。

摘　　要：目的探讨不同体位CT检查对腹壁切口疝容积评估的影响。方法采用回顾性病例对照研究方法。收集2017年2—9月中山大学附属第六医院收治的23例腹壁切口疝患者的临床资料;男14例,女9例;平均年龄为63岁,年龄范围为47~75岁。患者均行仰卧位和侧卧位全腹部CT扫描检查,在工作站进行多平面重组及容积再现,测量不同体位时疝囊容积、腹腔容积、疝囊与腹腔容积比。观察指标:(1)腹壁切口疝患者不同体位CT检查情况。(2)腹壁切口疝患者不同体位CT检查疝囊与腹腔容积比增加值的相关性分析。正态分布的计量资料以Mean±SD表示,组间比较采用配对t检验。计数资料以绝对值或百分比表示。采用Pearson相关性分析腹壁切口疝患者不同体位CT检查疝囊与腹腔容积比的增加值。结果(1)腹壁切口疝患者不同体位CT检查情况:23例腹壁切口疝患者侧卧位CT检查结果与仰卧位CT检查结果比较,侧卧位时疝内容物增多,腹壁变形,主要表现为腹腔横径变短,纵径变长。患者仰卧位和侧卧位CT检查疝囊容积分别为(623±293)mL和(869±425)mL,两者比较,差异有统计学意义(t=-7.959,P<0.05)。患者仰卧位和侧卧位CT检查腹腔容积分别为(6445±1438)mL和(6283±1348)mL,两者比较,差异有统计学意义(t=2.762,P<0.05)。患者仰卧位和侧卧位CT检查疝囊与腹腔容积比分别为0.096±0.040和0.138±0.061,两者比较,差异有统计学意义(t=-8.093,P<0.05)。患者侧卧位CT检查疝囊与腹腔容积比平均值较仰卧位增加了0.042,增加率为43.8%。23例患者仰卧位CT检查疝囊与腹腔容积比均<20%,而4例患者侧卧位CT检查疝囊与腹腔容积比>20%。(2)腹壁切口疝患者不同体位CT检查疝囊与腹腔容积比增加值的相关性分析:Pearson相关性分析结果显示,患者仰卧位CT检查疝囊与腹腔容积比与侧卧位CT检查疝囊与腹腔容积比的增加值呈正相关(r=0.742,P<0.05)。结论腹壁切口疝Objective To investigate the effects of computed tomography(CT)examination in different body positions on the evaluation of abdominal incisional hernia volume.Methods The retrospective case control study was conducted.The clinical data of 23 patients with abdominal incisional hernia who were admitted to the Sixth Affiliated Hospital of Sun Yat sen University from February to September in 2017 were collected.There were 14 males and 9 females,aged from 47 to 75 years,with an average age of 63 years.All patients underwent CT scan in supine position and lateral position.The volume of hernia sac,abdominal cavity and the volume ratio of hernia sac to abdominal cavity in different body positions were measured by multi planar reconstruction and volume reappearance on the workstation.Observation indicators:(1)situations of CT examination of patients with abdominal incisional hernia in different positions;(2)correlation analysis of volume ratio increment of hernia sac to abdominal cavity between different positions by CT examination in patients with abdominal incisional hernia.Measurement data with normal distribution were expressed as Mean±SD,and comparison between groups was performed using the pared t test.Count data were expressed as absolute numbers or percentages.Pearson correlation was used to analyze the volume ratio increment of hernia sac to abdominal cavity between different positions by CT examination in patients with abdominal incisional hernia.Results(1)Situations of CT examination of patients with abdominal incisional hernia in different positions:CT examination of 23 patients with abdominal incisional hernia showed that the contents of hernia increased and the abdominal wall deformed in the lateral position compared with conventional supine position,with manifestations as shortened abdominal transverse diameter and longer vertical diameter.The volume of the hernia sac in supine position and in lateral position by CT examination was(623±293)mL and(869±425)mL,respectively,showing a significant difference(t

关 键 词：疝 切口疝 体位 X线计算机 体层摄影术 疝囊容积 腹腔容积 容积比 

分 类 号：R47[医药卫生—护理学]