MSCT对评估粪石性小肠梗阻保守治疗可通过性的价值研究  

The Value of MSCT in Evaluating the Passability of Conservative Treatment for Small Intestinal Obstruction Caused by Bezoar

作　　者：杲霄源 孟红秀 董立杰 陈亮[1] 张林[1] 姜兴岳[1] 花义同 GAO Xiaoyuan;MENG Hongxiu;DONG Lijie(Department of Radiology,Binzhou Medical University Hospital,Binzhou,Shandong Province 256603,P.R.China)

机构地区：[1]滨州医学院附属医院放射科,256603 [2]滨州医学院附属医院乳腺外科,256603 [3]无棣县人民医院消化内科,251900

出　　处：《临床放射学杂志》2022年第1期112-115,共4页Journal of Clinical Radiology

基　　金：山东省自然科学基金项目(编号:ZR2018LH015);滨州医学院科技计划项目(编号:BY2011KJ041)。

摘　　要：目的探讨多层螺旋CT(MSCT)及其重组技术对粪石性小肠梗阻保守治疗可通过性的评估价值。方法搜集本院经手术及临床证实的50例粪石性小肠梗阻患者,根据保守治疗后粪石是否通过,分为通过组和非通过组,所有患者均在治疗前1天内行全腹MSCT扫描,并根据MSCT图像追溯粪石梗阻的部位,测量粪石短径、粪石长径、粪石平均CT值、梗阻段小肠扩张程度,观察有无肠壁增厚(肠壁厚度>3 mm)、有无腹腔积液、有无肠系膜水肿,记录数据,并对所有数据进行单因素分析及Logistics多因素线性回归分析,比较两组数据间的差异。结果经单因素分析及多因素分析发现,两组在粪石短径、梗阻部位、有无腹腔积液以及有无肠系膜水肿之间均存在统计学差异(P<0.05)。结论通过MSCT及其重组技术来测量粪石短径、追溯梗阻部位、观察有无腹腔积液和肠系膜的水肿,对于评估粪石性小肠梗阻保守治疗的可通过性具有重要的临床价值。Objective To evaluate the efficacy of MSCT and its recombination technique in the conservative treatment of small intestinal obstruction caused by bezoar. Methods 50 patients with small bowel obstruction caused by bezoar confirmed by operation and clinical examination in our hospital were collected and divided into the passed group and the non-passed group according to whether the bezoar passed after conservative treatment.All patients underwent a full-abdominal MSCT scan within 1 day before treatment.The sites of the obstruction, the short diameter of the bezoar, the long diameter of the bezoar, the mean CT value of the bezoar, and the dilatation of the small intestine in the obstructed segment were measured.The intestinal wall thickening(intestinal wall thickness > 3 mm),ascites and mesenteric edema were observed according to the MSCT images.Univariate analysis and logistic multivariate linear regression analysis were carried out for all the data to compare the differences between the two groups. Results The univariate analysis and multivariate analysis showed that there were significant differences between the two groups in the short diameter, obstructedsite, ascites and mesenteric edema(P<0.05). Conclusion MSCT and its recombination technique can be used to measure the short diameter of bezoar, trace the site of obstruction, and observe the presence of ascites and mesenteric edema, which has important clinical value in evaluating the feasibility of conservative treatment of small bowel obstruction caused by bezoar.

关 键 词：多层螺旋CT 粪石 小肠梗阻 

分 类 号：R574.2[医药卫生—消化系统]