超声影像诊断急性化脓性胆囊炎的临床价值研究  

Clinical Value Research of Ultrasound Imaging in Diagnosis of Acute Suppurative Cholecystitis

作　　者：迟新梅 孙开荣 马桂芬 CHI Xinmei;SUN Kairong;MA Guifen(Linqu County Xinzhai Central Health Hospital,Linqu,Shandong 262600;Weifang Endocrine and Metabolic Disease Hospital,Weifang,Shandong 262600)

机构地区：[1]临朐县辛寨中心卫生院,山东临朐262600 [2]潍坊内分泌与代谢病医院,山东临朐262600

出　　处：《智慧健康》2023年第28期5-9,共5页Smart Healthcare

摘　　要：目的明确超声影像诊断在急性化脓性胆囊炎治疗中的临床应用价值,研究和分析超声影像特点,以实现更精准的诊断和更有效的治疗。方法将本院于2022年2月—2023年2月收治的40例急性单纯性胆囊炎患者作为单纯组进行研究,将本院于同时期收治的40例急性化脓性胆囊炎患者作为化脓组进行研究。两组患者均接受腹腔镜下的胆囊切除手术以及术后的组织病理学查验。将两组患者的典型性超声特点及胆囊超声阳性率进行手术前后的对比分析,并检测和评价两组患者的肝功能各项指标及外周血白细胞计数情况。结果两组患者经超声影像检测均存在胆囊炎疾病的典型临床表征,且在症状检出率上,化脓组显著高于单纯组。如化脓组胆液透声差检出率为85.0%,高于单纯组的50.00%;化脓组胆囊壁增厚或凹凸不平检出率为92.5%,高于单纯组的62.5%;化脓组胆囊肿大检出率为82.50%,高于单纯组的60.00%;化脓组Murphy征阳性检出率为92.00%,高于单纯组的20.00%,上述差异均具有统计学意义(P<0.05)。在肝功能各项指标(AST、ALB)以及血清总胆红素(TBIL)和白细胞计数(WBC)方面,两组患者在术前无显著差异(P>0.05),术后化脓组上述各项指标均高于单纯组,差异具有统计学意义(P<0.05)。另外,在化脓组40例患者中,误诊为胆汁淤积症者1例(2.5%),误诊为单纯性肝内胆管结石者1例(2.5%),误诊为急性单纯性胆囊炎者2例(5.00%)。结论在急性化脓性胆囊炎患者的临床诊断中彩色多普勒超声检查可提供准确、可靠的影像诊断依据,可对患者的临床表征如胆液透声、胆囊形态、胆囊壁厚度及Murphy征等进行准确评价,具有临床推广应用价值。Objective To clarify clinical application value of ultrasound imaging in diagnosis of acute suppurative cholecystitis,study and analyze characteristics of ultrasound imaging to achieve more accurate diagnosis and effective treatment.Methods The paper chose 40 patients with acute simple cholecystitis admitted to our hospital from February 2022 to February 2023 as simple group,and 40 patients with acute suppurative cholecystitis admitted to our hospital during the same period as suppurative group.Both groups were treated with laparoscopic cholecystectomy and postoperative histopathological examination.Typical ultrasound characteristics and gallbladder ultrasound positive rates were compared and analyzed between two groups before and after surgery,liver function indicators and peripheral blood leukocyte count were detected and evaluated between two groups.Results Both groups showed typical clinical manifestations of cholecystitis through ultrasound imaging,symptom detection rate in suppurative group was significantly higher than simple group.Detection rate of differential sound transmission in suppurative group was 85.0%,higher than 50.00%in simple group;detection rate of gallbladder wall thickening or unevenness in suppurative group was 92.5%,higher than 62.5%in simple group;detection rate of gallbladder enlargement in suppurative group was 82.50%,higher than 60.00%in simple group;positive detection rate of Murphy's sign in suppurative group was 92.00%,higher than 20.00%in simple group,above difference was statistically significant(P<0.05).Various indicators of liver function(AST,ALB),serum total bilirubin(TBIL),and white blood cell count(WBC)showed no significant difference between two groups before surgery(P>0.05).Above indicators in postoperative suppurative group were higher than simple group,difference was statistically significant(P<0.05).in addition,among 40 cases in suppurative group,1 case was misdiagnosed as cholestasis(2.5%),1 case misdiagnosed as simple intrahepatic bile duct stones(2.5%),and 2 cases mi

关 键 词：超声影像 急性化脓性胆囊炎 临床价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.61[医药卫生—诊断学]