NLR检测联合腹部CTA诊断绞窄性肠梗阻的临床研究  

Clinical study of NLR detection combined with abdominal CTA in diagnosis of strangulated intestinal obstruction

作　　者：赵鹏举 艾可为 杨兴广 李逸 李正亮 杨继武 ZHAO Pengju;AI Kewei;YANG Xingguang;LI Yi;LI Zhengliang;YANG Jiwu(Second Department of General Surgery,First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China;Department of Radiology,First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China)

机构地区：[1]大理大学第一附属医院普外二科,云南大理671000 [2]大理大学第一附属医院放射科,云南大理671000

出　　处：《重庆医学》2022年第22期3859-3863,共5页Chongqing medicine

基　　金：云南省教育厅科学研究基金(2020Y0558)。

摘　　要：目的分析中性粒细胞/淋巴细胞(NLR)检测联合腹部CT血管造影(CTA)检查对绞窄性肠梗阻的诊断价值。方法选取2019年6月至2021年6月在该院完成手术治疗的100例肠梗阻患者作为研究对象,所有患者术前均接受NLR检测及腹部CTA检查,术中根据肠壁缺血情况分为单纯组(单纯性肠梗阻)和绞窄组(绞窄性肠梗阻),绘制受试者工作特征(ROC)曲线得出NLR诊断绞窄性肠梗阻的最佳阈值,并以术中检查结果为“金标准”,分析术前NLR检测联合CTA检查对绞窄性肠梗阻的诊断效能。结果纳入的100例肠梗阻患者,经手术确诊为单纯肠梗阻62例(单纯组)、绞窄性肠梗阻38例(绞窄组);绞窄组患者入院时视觉模拟评分(VAS)、NLR值高于单纯组,差异有统计学意义(P<0.05);2组其他资料比较,差异无统计学意义(P>0.05);ROC曲线图显示,NLR诊断绞窄性肠梗阻的曲线下面积(AUC)为0.751,有一定诊断价值;以手术检查结果为“金标准”,NLR检测联合腹部CTA诊断绞窄性肠梗阻的准确度、敏感度、阴性预测值均高于单一使用术前NLR检测或腹部CTA检查,差异有统计学意义(P<0.05)。结论NLR检测和腹部CTA诊断均可鉴别单纯性肠梗阻和绞窄性肠梗阻,NLR检测联合腹部CTA可提高不同类型肠梗阻的鉴别效能,从而提高诊断绞窄性肠梗阻的准确性。Objective To analyze the diagnostic value of neutrophil/lymphocyte ratio(NLR)detection combined with abdominal CT angiography(CTA)in strangulated intestinal obstruction.Methods One hundred patients with intestinal obstruction who completed surgical treatment in this hospital from June 2019 to June 2021 were selected as the research subjects,all patients received the NLR detection and abdominal CTA before operation.According to the ischemic situation of intestinal wall during operation,the patients were divided into the simple group(simple intestinal obstruction)and the strangulation group(strangulation intestinal obstruction),the receiver operating characteristic(ROC)curve was drawn to obtain the best threshold value for NLR in diagnosing strangulated intestinal obstruction.The intraoperative examination results were taken as the“gold standard”,the diagnostic efficiency of preoperative NLR detection combined with CTA in strangulated intestinal obstruction was analyzed.Results Among the 100 included cases of intestinal obstruction,62 cases were diagnosed as simple intestinal obstruction(the simple group)by operation and 38 cases as strangulated intestinal obstruction(the strangulation group);the score of visual analogue scale(VAS)and NLR value at admission of the patients in the strangulation group were higher than those of the patients in the simple group,and the differences were statistically significant(P<0.05);there was no statistical significant difference in other data between the two groups(P>0.05);the receiver operating characteristic(ROC)curve was drawn and showed that the area under the curve(AUC)of NLR for diagnosing strangulated intestinal obstruction was 0.751,which had certain diagnostic value;the results of surgical examination were taken as the“gold standard”,the accurac y,sensitivity and negative predictive value of NLR detection combined with ab-dominal CTA in the diagnosis of strangulated intestinal obstruction were higher than those of preoperative NLR or abdominal CTA alone,the differe

关 键 词：绞窄性肠梗阻 中性粒细胞 淋巴细胞 血管造影CT 诊断效能 

分 类 号：R814.42[医药卫生—影像医学与核医学]