腹部超声与结肠镜在缺血性结肠炎早期诊断中的价值  

Value of Transabdominal Ultrasonography and Colonoscopy in Early Diagnosis of Ischemic Colitis

作　　者：张真真[1] 武琳蓓 师晓娜 ZHANG Zhen-zhen;WU Lin-bei;SHI Xiao-na(CCU,Department of Cardiology,the First Affiliated Hospital of Sci-tech University,Luoyang,Henan 471003)

机构地区：[1]河南科技大学第一附属医院心内科CCU,河南洛阳471003

出　　处：《中国肛肠病杂志》2023年第10期39-42,共4页Chinese Journal of Coloproctology

摘　　要：目的:分析探讨腹部超声与结肠镜在缺血性结肠炎早期诊断中的价值。方法:选择我院2021年1月至2022年1月经手术病理活检确诊的47例缺血性结肠炎患者,其中病变位置:左半结肠30例,右半结肠4例,降结肠2例,乙状结肠2例,横结肠5例,脾曲4例。采用经腹部超声及结肠镜诊断,分析腹部超声及结肠镜的图像特征,并观察比较2种检查方法的病变部位诊断率。结果:腹部超声共诊断出40例缺血性结肠炎,结肠镜共诊断出45例缺血性结肠炎,诊断率分别是85.11%、95.74%。经腹部超声诊断出左半结肠27例,诊断率为90.00%;右半结肠2例,诊断率为50.00%;降结肠2例,诊断率为100.00%;乙状结肠2例,诊断率为100.00%;横结肠4例,诊断率为80.00%;脾曲3例,诊断率为75.00%。经结肠镜诊断出左半结肠29例,诊断率为96.67%;右半结肠4例,诊断率为100.00%;降结肠2例,诊断率为100.00%;乙状结肠2例,诊断率为100.00%;横结肠4例,诊断率为80.00%;脾曲4例,诊断率为100.00%。经腹部超声与结肠镜诊断部位比较,差异无统计学意义(P>0.05)。结论:超声诊断具有较高的分辨率,不但可以观察到肠外情况,还可以见到肠壁内的结构层次,同时彩色多普勒可评估到肠壁间的血流情况。同时经腹部超声诊断缺血性结肠炎能获得与结肠镜相同诊断价值,针对不耐受结肠镜检查的患者,可将腹部超声作为诊断缺血性结肠炎替代结肠镜的首选方法。Objective To analyze the value of transabdominal ultrasonography(TAUS)and colonoscopy in the early diagnosis of ischemic colitisM.Iethods Total 47 patients with ischemic colitis diagnosed by surgical pathological biopsy in our hospital from January 2021 to January 2022 were selected.In terms of lesion location,30 cases were in the left hemicolon,4 cases in the right hemicolon,2 cases in the descending colon,2 cases in the sigmoid colon,5 cases in the transverse colon,and 4 cases in the splenic flexure.TAUS and colonoscopy were used for diagnosis.The image characteristics of TAUS and colonoscopy were analyzed to compare the diagnostic rates of the lesions of the two examination methods.Results A total of 40O cases of ischemic colitis were diagnosed by TAUS and 45 cases by colonoscopy,the diagnostic rates were 85.11%and 95.74%,respectively.The left hemicolon was diagnosed by TAUS in 27 cases,the diagnostic rate was 90.00%.The diagnosis rate of right hemicolon was 50.00%in 2 cases.The diagnosis rate of descending colon was 100.00%in 2 cases.There were 2 cases of sigmoid colon,the diagnostic rate was 100.00%.The diagnosis rate of transverse colon was 80.00%in 4 cases.Splenic flexure was found in 3 cases,the diagnostic rate was 75.00%.The left hemicolon were diagnosed by colonoscopy in 29 cases,the diagnosis rate was 96.67%.The diagnosis rate of right hemicolon was 100.00%in 4 cases.The diagnosis rate of descending colon was 100.00%in 2 cases.There were 2 cases of sigmoid colon,the diagnostic rate was 100.00%.The diagnosis rate of transverse colon was 80.00%in 4 cases.Splenic flexure was found in 4 cases,the diagnostic rate was 100.00%.There was no significant difference between the diagnostic sites of TAUS and colonoscopy(P>0.05).Conclusion Ultrasound diagnosis has a high resolution,which can not only observe the outside of the intestine but also examine the structure of the intestinal wall.Color Doppler can evaluate the blood flow between the intestinal walls.At the same time,the diagnosis of ischemic colitis by TAU

关 键 词：缺血性结肠炎 腹部超声 结肠镜 诊断 图像特征 

分 类 号：R574.62[医药卫生—消化系统]