CT直接和间接征象在肠穿孔术前诊断中的价值  

The value of direct and indirect CT signs in preoperative diagnosis of intestinal perforation

作　　者：周政[1] 王立环 李卫平[2] 徐小慧 顾文豪[1] 许大波 ZHOU Zheng;WANG Lihuan;LI Weiping;XU Xiaohui;GU Wenhao;XU Dabo(Imaging Center,Taicang Hospital Affiliated to Soochow University,Taicang,Jiangsu Province 215400,China;Department of General Surgery,Taicang Hospital Affiliated to Soochow University,Taicang,Jiangsu Province 215400,China)

机构地区：[1]苏州大学附属太仓医院影像中心,江苏太仓215400 [2]苏州大学附属太仓医院普外科,江苏太仓215400

出　　处：《实用放射学杂志》2023年第6期950-953,共4页Journal of Practical Radiology

摘　　要：目的探讨CT直接征象及间接征象对肠穿孔术前诊断的临床价值。方法回顾性分析经手术证实的44例肠穿孔患者临床及CT表现,将CT表现分为直接征象和间接征象。将所有患者以具备直接征象(A组)、间接征象≥3个(B组)及间接征象<3个(C组)作为诊断条件分为3组,以术中诊断作为金标准,对各组术前诊断符合率进行对比分析,同时对好转及治愈的患者平均住院时间进行统计。结果诊断符合率比较:A组100%;B组84%;C组40%。3组间肠穿孔诊断符合率差异有统计学意义(P<0.05);而A组与B组组间比较差异无明显统计学意义(P>0.05);B组与C组组间比较差异有统计学意义(P<0.05)。平均住院时间比较:A组(13.5±6.21)d;B组(17.2±8.34)d;C组(28.1±22.9)d。A组与B组比较差异无明显统计学意义(P>0.05);B组与C组比较差异有统计学意义(P<0.05)。结论CT直接征象对肠穿孔的诊断价值高,可明显减少患者平均住院时间;当直接征象不显著时,间接征象越多,诊断准确性越高,患者平均住院时间也越少。Objective To discuss the clinical value of direct and indirect CT signs in preoperative diagnosis of intestinal perforation.Methods Clinical signs and CT findings in 44 patients with intestinal perforation confirmed by surgery were analyzed retrospectively.Those CT findings were classified as direct signs and indirect signs.All patients were divided into three groups according to the CT findings,with direct signs(group A),with indirect signs≥3(group B)and with indirect signs<3(group C).Taking intraoperative diagnosis as the gold standard,the conformance rates of preoperative diagnosis in each group were compared and analyzed,and the average hospital stay of improved and cured patients were counted.Results Comparison of diagnostic conformance rates:group A was 100%;group B was 84%;and group C was 40%.There was a significant difference in the diagnostic conformance rate of intestinal perforation among the three groups(P<0.05),however,no significant difference between group A and group B(P>0.05),but a significant difference between group B and group C(P<0.05).The average hospital stay in group A was(13.5±6.21)days;group B was(17.2±8.34)days;and group C was(28.1±22.9)days.There was no significant difference between group A and group B(P>0.05),but a significant difference between group B and group C(P<0.05).Conclusion Direct signs in CT findings shows high diagnostic value for intestinal perforation,and the average hospital stay of patients with direct signs is significantly shorter;among the patients without direct signs,the more indirect signs,the higher the diagnostic accuracy,and the less the average hospital stay of patients.

关 键 词：肠穿孔 直接征象 间接征象 计算机体层成像 

分 类 号：R574[医药卫生—消化系统] R814.42[医药卫生—内科学]