CT平扫对成人绞窄性小肠梗阻的诊断价值  

The diagnostic value of CT plain scan for adult strangulated small bowel obstruction

作　　者：田晶 康星[2] 周竹萍[3] 汪灏[2] 管文贤[2] 王军[1] 何健[3] TIANJing;KANGXing;ZHOUZhuping;WANG Hao;GUAN Wenxian;WANGJun;HEJian(Department of Emergency,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing,210008,China;Department of General Surgery,the Affiliated Drum Tower Hospital of Nanjing University Medical School;Department of Radiology,the Affiliated Drum Tower Hospital of Nanjing University Medical School)

机构地区：[1]南京医科大学鼓楼临床医学院急诊中心,南京210008 [2]南京大学医学院附属鼓楼医院普外科 [3]南京大学医学院附属鼓楼医院放射科

出　　处：《临床急诊杂志》2021年第4期270-274,共5页Journal of Clinical Emergency

基　　金：国家科技部项目(No:2016YFC0104105)。

摘　　要：目的:探讨对成人绞窄性小肠梗阻(SSBO)有预测价值的CT征象。方法:回顾分析南京医科大学鼓楼临床医学院11年内住院治疗的487例急性小肠梗阻(SBO)资料,采集临床表现、15种CT平扫征象、手术及病理学资料。用多因素回归法比较绞窄性梗阻和单纯性梗阻患者CT征象的差异。结果:绞窄组259例,单纯组228例。单因素分析结果显示,有7个CT平扫征象与SSBO相关,分别是肠系膜积液征、肠壁增厚征、腹水征、肠系膜脂肪密度增高征、肠壁密度增高征及缆绳征、鸟嘴征。多因素回归分析结果提示,有5个CT征象与SSBO密切相关,按其作用强弱依次为:肠系膜积液征(OR=15.165)、腹水(OR=6.359)、肠系膜脂肪密度增高(OR=5.891)、肠壁密度增高征(OR=4.026)、肠壁增厚征(OR=2.026)。结论:Logistic回归方程显示,肠系膜积液征、腹水、肠系膜脂肪密度增高、肠壁密度增高征、肠壁增厚征等CT征象对成人SSBO具有一定预测价值。Objective: To explore the predictive variables of CT signs for adult strangulated small bowel obstruction(SSBO) and investigate the diagnostic value of CT scan for SSBO. Methods: The clinical data of 487 cases with small bowl obstruction(SBO) who were admitted to the hospital of Drum Tower Clinical College of Nanjing Medical University from June 2010 to January 2021 were analyzed retrospectively. The clinical manifestations, 15 kinds of CT scan signs, clinical operation and pathological data were collected in each patient. The differences of CT scans between SSBO group and simple group were compared by multivariate regression equation. Results: There were 259 patients in the strangulation group and 228 patients in the simple group. Univariate analysis of the data indicated that there were 7 significant factors related to SSBO, including mesenteric effusion sign, bowel wall thickening sign, ascites sign, mesenteric fat density syndrome, increased intestinal wall density sign, cable sign, and beak sign. The multivariate logistic regression analysis showed that there were statistically significant in 5 risk factors, according to the intensity of the effects was as follows: mesenteric effusion(OR=15.165), ascites(OR=6.359), mesenteric fat density syndrome(OR=5.891), increased intestinal wall density(OR=4.026), bowel wall thickening(OR=2.026). Conclusion: Regression analysis of multiple preoperative criteria demonstrates that mesenteric effusion, ascites, mesenteric fat density syndrome, increased intestinal wall density, and intestinal wall thickened signs are the variables predictive of SSBO.

关 键 词：急性小肠梗阻 绞窄性肠梗阻 CT 

分 类 号：R656.1[医药卫生—急诊医学] R656.7[医药卫生—外科学]