72例麦克尔憩室的术前诊断分析  

The preoperative diagnosis analysis of 72 cases with Meckel diverticulum

作　　者：陈颖[1] 唐永华[2] 陈双庆[1] 胡春洪[3] Chen Ying;Tang Yonghua;Chen Shuangqing;Hu Chunhong(Department of Radiology,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou 215002,China;Department of Radiology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 20003,China;Department of Radiology,The First Affiliated Hospital of Soochow University,Shuzhou 215006,China)

机构地区：[1]南京医科大学附属苏州医院放射科,215002 [2]上海交通大学附属瑞金医院放射科,200030 [3]苏州大学附属第一医院放射科,215006

出　　处：《中华诊断学电子杂志》2020年第4期258-264,共7页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨不同影像学检查和内镜检查对麦克尔憩室的术前诊断价值和合理的诊断路径。方法回顾性分析2008年1月至2018年12月上海交通大学附属瑞金医院、南京医科大学附属苏州医院和苏州大学附属第一医院经手术或内镜证实的72例麦克尔憩室患者的影像学和内镜检查资料,按不同年龄(儿童组和成人组)和症状(出血组和腹痛组)分组比较不同检查方式的诊断率。结果各检查对麦克尔憩室的诊断率分别为:异位胃黏膜显像50.00%(3/6),数字减影血管造影12.50%(1/8),CT平扫7.14%(1/14),CT增强14.29%(1/7),CT小肠造影(CTE)57.45%(27/47),胶囊内镜(CE)16.00%(4/25),双气囊小肠镜(DBE)95.83%(46/48)。CTE对麦克尔憩室的诊断率高于其他CT检查方式(均P<0.05)。CTE对出血组的诊断率高于腹痛组(χ^2=6.27,P<0.05),但儿童组和成人组的诊断率差异无统计学意义(χ^2=0.59,P>0.05)。DBE的诊断率高于CE和CTE(χ^2=36.54,16.47;P<0.01),CTE的诊断率高于CE(χ^2=8.13,P<0.01)。结论诊断率高的3种检查依次为DBE、CTE、CE,CTE诊断率高于其他CT检查方式,且对出血性憩室的诊断率高。宜根据不同的年龄段和症状选择合适的诊断路径。Objective To explore the value of different imageological and endoscopy examinations in preoperative diagnosis of Meckel diverticulum,and the reasonable diagnostic flowchart.Methods From January 2008 to December 2018,the data of imaging and endoscopic examinations of 72 patients with Meckel diverticulum confirmed by surgery or endoscopy who were collected from Ruijin Hospital Affiliated to Shanghai Jiao Tong University,Suzhou Hospital Affiliated to Nanjing Medical University,and the First Affiliated Hospital of Soochow University were retrospectively analyzed.The study was grouped according to different ages(children and adults)and symptoms(bleeding and abdominal pain),and the diagnostic rates of different examinations were compared.Results The diagnostic rates of radionuclide scintigraphy,digital subtraction angiography,non-enhanced CT,contrast enhanced CT,computed tomography enterography(CTE),capsule endoscopy(CE)and double-balloon enteroscopy(DBE)were 50.00%(3/6),12.50%(1/8),7.14%(1/14),14.29%(1/7),57.45%(27/47),16.00%(4/25)and 95.83%(46/48),respectively.The diagnostic rate of CTE was higher than that of other CT methods(all P<0.05).The diagnostic rate of CTE in bleeding group was higher than that in abdominal pain group(χ^2=6.27,P<0.05),and there was no statistically significant difference between child group and adult group(χ2=0.59,P>0.05).The diagnostic rate of DBE was higher than those of CE and CTE(χ^2=36.54,16.47,all P<0.01),and the diagnostic rate of CTE was higher than that of CE(χ^2=8.13,P<0.01).Conclusions The three kinds of examinations with high diagnostic rate are DBE,CTE,CE successively.The diagnostic rate of CTE is higher than that of other CT methods,and it has a high diagnostic rate in hemorrhagic diverticulum.Reasonable diagnostic flowchart should be used according to different ages and symptoms.

关 键 词：麦克尔憩室 手术前期 诊断 内窥镜检查 消化系统 

分 类 号：R57[医药卫生—消化系统]