胸片与胃肠透视结合在提高膈疝诊断中的应用分析  

The Application of Chest Radiography Combined with Gastrointestinal Fluoroscopyin Improving the Diagnosis of Diaphragmatic Hernias

作　　者：段莉娜 杜飞 罗颖 Duan Li'na;Du Fei;Luo Ying(Department of Radiology,Hebi People's Hospital,Hebi 458030)

机构地区：[1]鹤壁市人民医院放射科,鹤壁458030

出　　处：《数理医药学杂志》2021年第9期1385-1388,共4页Journal of Mathematical Medicine

摘　　要：目的:分析胸片结合胃肠透视应用于膈疝的诊断效果。方法:回顾性分析某院2019年1月~2020年12月期间收治的30例创伤性膈疝患者的临床资料,所有患者均经手术证实,术前行胸片结合胃肠透视检查,以手术结果为金标准,观察胸片结合胃肠透视的诊断准确率。结果:以手术结果为金标准,30例膈疝患者经胸部X线结合胃肠透视检查确诊26例,诊断准确率86.67%。影像学表现为:内含气体影13例(43.33%)、内含气液面影10例(33.33%)、心影下部密度增高影6例(20.00%)、呈空洞样变6例(20.00%)、心后区团块影3例(10.00%)、胸骨后前肋膈角区团块状影和单侧肺野蜂窝状及肠管状影各2例(6.67%)。结论:创伤性膈疝术前行胸片X线结合胃肠钡餐造影检查,可明显见X线异常改变,再辅助胃肠透视,借助X线对造影剂的照射,可有效提高诊断效果,对术前定位及手术方法的制定具有重要的意义。Objective:To analyze the efficacy of chest radiography combined with gastrointestinal fluoroscopy in the diagnosis of diaphragmatic hernias.Methods:A total of 30 patients with traumatic diaphragmatic hernia who were admitted to a hospital from January 2019 to December 2020 were retrospectively evaluated.All patients were confirmed by surgery,and preoperative chest radiography combined with gastrointestinal fluoroscopy was performed,and the diagnostic accuracy of chest radiograph combined with gastrointestinal fluoroscopy was observed by using the surgical results as the gold standard.Results:Taking the surgical results as the gold standard,26 cases were diagnosed by chest X-ray combined with gastrointestinal fluoroscopy in 30 patients with diaphragmatic hernia,and the diagnostic accuracy was 86.67%.The imaging findings were as follows:13 cases(43.33%)with gas-liquid shadowing,10 cases(33.33%)with liquid surface shadowing,6 cases(20.00%)with dense shadow at the lower part of the heart shadow,6 cases(20.00%)with cavitary transformation,3 cases(10.00%)with agglomerated shadow at the posterior area of the sternum,2 cases(6.67%)with agglomerated shadow at anterior costophrenic angle area,and 2 cases(6.67%)with wild honeycomb and intestinal shadow at unilateral lung field.Conclusion:Chest X-ray combined with gastrointestinal barium meal radiography before operation for traumatic diaphragmatic hernia can reveal abnormal X-ray changes,which are further assisted by gastrointestinal fluoroscopy,can effectively improve the diagnosis with the aid of X-ray irradiation of contrast medium,and is of great significance for preoperative localization and the development of surgical methods.

关 键 词：膈疝 影像学诊断 胸片X线 胃肠透视 

分 类 号：R445.4[医药卫生—影像医学与核医学]