粘连性小肠梗阻中带状粘连和膜状粘连的CT特征分析  

CT-guided diagnosis of banded vs membranaceous adhesive small bowel obstruction

作　　者：魏永[1] 陈智勇[2] 林炳锵[1] 廖天然[1] 张俊榕 欧阳漫多 陈先强[1] Wei Yong;Chen Zhiyong;Lin Bingqiang;Liao Tianran;Zhang Junrong;Ouyang Manduo;Chen Xianqiang(Department of Emergency Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Radiology,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院急诊外科(普通外科),福州350001 [2]福建医科大学附属协和医院放射科,福州350001

出　　处：《中华普通外科杂志》2023年第6期441-444,共4页Chinese Journal of General Surgery

基　　金：福建省卫健委推广项目(2021TG007);福建省卫健委中青年骨干人才培养项目(2020GGA034);福建省医疗“创双高”建设经费资助[闽卫医政(2021)76号]。

摘　　要：目的:研究粘连性小肠梗阻中带状粘连和膜状粘连的CT影像学特征。方法:回顾性分析150例粘连性小肠梗阻手术患者,根据手术中发现分为带状粘连和膜状粘连两组,比较两组患者的临床特征和CT特征,采用Logistic回归分析预测带状粘连的独立危险因素。结果:两组患者的带状粘连和膜状粘连中闭襻征(36.8%比14.3%,P=0.002)、肠系膜模糊征(43.7%比17.5%,P=0.001)、鸟嘴征(48.3%比17.5%,P<0.001)、脂肪切迹征(39.1%比9.5%,P<0.001)、腹腔积液(54.0%比34.9%,P=0.015)差异均有统计学意义。Logistic回归分析发现,鸟嘴征[OR=6.15,95%CI(2.55~14.84),P<0.001]、脂肪切迹征[OR=6.19,95%CI(2.16~17.82),P=0.001]、肠系膜模糊征[OR=3.34,95%CI(1.34~8.32),P=0.009]是预测带状粘连的独立危险因素。结论:鸟嘴征、脂肪切迹征、肠系膜模糊征是预测带状粘连的独立危险因素。Objectives To study the computed tomography features of banded adhesions(BA)and matted adhesions(MA)of adhesive small bowel obstruction(ASBO).Methods We enrolled 150 patients operated on for ASBO.According to intraoperated findings,ASBO were classified into those caused by BA or MA.A multivariable logistic regression was established to analyze independent risk factors on Computed Tomography features.ResulstsThere were significant differences in closed-loop sign(36.8%vs.14.3%,P=0.002)mesenteric haziness(43.7%vs.17.5%,P=0.001),beak sign(48.3%vs.17.5%,P<0.001),fat notch sign(39.1%vs.9.5%,P<0.001)and peritoneal fluid(54.0%vs.34.9%,P=0.015)between the two groups.The presence of beak sign[0R=6.15,95%CI(2.55-14.84),P<0.001],fat notch sign[0R=6.19,95%CI(2.16-17.82),P=0.001]and mesenteric haziness[0R=3.34,95%CI(1.34-8.32),P=0.009]were independent risk factors with BA.Conclusion Beak sign,fat notch sign and mesenteric haziness were independent risk factors for diagnosing BA.

关 键 词：肠梗阻 组织粘连 体层摄影术 X线计算机 

分 类 号：R656.7[医药卫生—外科学]