急性肠系膜血管梗死中多排CT征象与肠梗死病变分期及预后的相关性研究分析  

Correlation of multidetector row CT in acute mesenteric vascular infarction with the stage and prognosis of intestinal infarct lesions

作　　者：王军 马丽苹 刘权 WANG Jun;MA Liping;LIU Quan(Department of Radiology,Xinyang People's Hospital,Xinyang,Henan 464000,China;Department of Radiology,the Third People's Hospital of Xinyang,Henan 464000,China)

机构地区：[1]信阳市人民医院放射科,河南信阳464000 [2]信阳市第三人民医院放射科,河南信阳464000

出　　处：《中国医学工程》2022年第9期70-73,共4页China Medical Engineering

摘　　要：目的 分析急性肠系膜血管梗死中多排CT征象与肠梗死病变分期及预后的相关性。方法 选择信阳市人民医院2018年6月至2020年6月收治的42例AMI患者作为研究对象,给予320CT平扫与增强扫描,图像后处理后,由两名医师对图像进行分析,分析动脉性、静脉性肠梗死的预后情况及CT征象分布情况,分析经治疗后存活患者与死亡患者的CT征象分布情况。结果 本研究中15例动脉性梗死患者存活3例(20.00%),死亡12例(80.00%);27例静脉性梗死患者存活17例(62.96%),死亡10例(37.04%);动脉性梗死患者的肠壁积气、门静脉积气、肠壁变薄、气腹、积粪征发生率均显著高于静脉性梗死患者(P<0.05);静脉性梗死患者的肠壁增厚、肠管扩张、肠壁增强、肠系膜水肿、腹腔积液发生率均显著高于动脉性梗死患者(P<0.05);动脉性梗死死亡率显著高于静脉性梗死组(χ~2=7.136, P=0.008);动脉性梗死患者的肠壁积气、门静脉积气、肠壁变薄、气腹、积粪征发生率均显著高于静脉性梗死患者(P<0.05);静脉性梗死患者的肠壁增厚、肠管扩张、肠壁增强、肠系膜水肿、腹腔积液发生率均显著高于动脉性梗死患者(P<0.05)。结论 急性肠系膜动脉性血管梗死具有更高的死亡风险,当CT征象显示有肠壁积气、肠壁变薄、气腹、门静脉积气、积粪征等征象时,预后较差。【Objective】 To analyze the correlation between multidetector row CT signs in acute mesenteric vascular infarction and the stage and prognosis of intestinal infarction lesions. 【Methods】 A total of 42 AMI patients treated in Xinyang People’s Hospital from June 2018 to June 2020 were selected for the study, given 320CT plain and enhanced scan, after image postprocessing, the images were analyzed by two physicians, the prognosis of arterial and venous intestinal infarction and the distribution of CT signs, the distribution of CT signs in patients who survived the treatment versus those who died were analyzed.【Results】 In this study, the patients with arterial infarction survived 3(20.00%) and died 12(80.00%);the patients with venous infarction survived 17(62.96%) and died 10(37.04%);the patients with arterial infarction had a significantly higher frequency of pneumatosis intestinalis, portal vein pneumatosis, bowel wall thinning, pneumoperitoneum, and faecal sign than the patients with venous infarction(P<0.05). The incidences of bowel dilation, bowel wall enhancement, mesenteric edema, and peritoneal effusion were all significantly higher in patients with arterial infarction(P<0.05), the mortality rate was significantly higher in patients with arterial infarction than in those with venous infarction(χ~2=7.136, P=0.008), and the incidences of pneumatosis intestinalis, portal pneumatosis, bowel wall thinning, pneumoperitoneum, and fecum were significantly higher in patients with arterial infarction than in patients with venous infarction(P<0.05), and patients with venous infarction had significantly higher rates of bowel wall thickening, bowel dilation, bowel wall enhancement, mesenteric edema, and peritoneal effusion than patients with arterial infarction(P<0.05). 【Conclusion】 Acute mesenteric arterial infarction(AMI) carries a higher risk of mortality and is associated with a worse prognosis when CT imaging shows signs of pneumatosis intestinalis, thinning of the bowel wall, pneumoperitoneum, por

关 键 词：急性肠系膜血管梗死 多排CT征象 动脉性梗死 静脉性梗死 预后 

分 类 号：R57[医药卫生—消化系统]