低高频超声联合应用诊断肠穿孔  

Applications Combining Low-frequency Ultrasound with High-frequency Ultrasound to Diagnosis of Intestinal Perforation

作　　者：沈铁柱 毕小霞[2] 高健[3] 黄小求 张全福[4] 张丽慧[2] 王海娟[2] 

机构地区：[1]唐山市开滦总医院林西医院超声科,河北省唐山市063100 [2]唐山市开滦总医院林西医院外科,河北省唐山市063100 [3]唐山市开滦总医院林西医院影像科,河北省唐山市063100 [4]唐山市开滦总医院林西医院检验科,河北省唐山市063100

出　　处：《中国超声医学杂志》2015年第3期231-234,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨低、高频超声联合应用诊断肠穿孔的超声特征及定位诊断价值。方法对比分析46例胃肠穿孔患者低、高频超声检查结果,以"双层气体征"及"小气泡征"方法进行腹腔游离气体的扫查,并与X线腹透检查结果进行对照;以局部肠管壁的"双轨征"、大网膜"包裹征"、"填塞征"及"聚集征"、肠壁节段性或局部增厚、扩张及肠管麻痹征、肠间局限性积液正确定位穿孔位置,且与病理结果相对照。结果 46例肠穿孔患者中通过观察"双层气体征"及"小气泡征"发现腹腔游离气体42例(91%),高于X线发现膈下游离气体34例(74%),两者差异显著性(P<0.05)。以局部肠壁"双轨征"、大网膜"包裹征"、"填塞征"及"聚集征"、肠壁节段性或局部增厚、扩张及肠管麻痹征、肠间局限性积液正确定位穿孔位置38例(83%);发现腹腔积液43例(93%);X线未能发现腹腔积液并且对穿孔部位做出定位诊断。结论在肠道穿孔诊断中,低、高频超声联合应用能发现X线不能发现的游离气体,且对肠穿孔定位中有重要的价值,为临床诊断及治疗提供了重要依据。Objective To explore the ultrasound characteristics and locating value of joint application of low-frequency ultrasound with high-frequency ultrasound.Methods The low and high-frequency ultrasound results of 46 patients with gastrointestinal perforation were comparatively analyzed.Free intraperitoneal gas was scanned as the basis of 'double gas sign' and 'small bubble sign'.And abdominal perspective examination results by X-ray were comparatively analyzed.The perforation location was correctly positioned aided by partial intestinal wall ' two-track' sign,Omentum's 'package' sign, ' Stuffing' sign and ' Gather' sign,segmental or partial bowel wall thickening and the expansion,intestinal paralysis and limited effusion between Intestinal.And the results were compared with the pathological findings.Results Among 46 patients with intestinal perforation,42 cases were found intraperitoneal free gas(91%)by observing the 'double gas sign' and ' Small bubble sign',34 cases were found free gas below the diaphragm(74%)by X-ray.The difference was significant(P<0.05).The perforation positions of 38 cases were correctly located by partial intestinal wall 'two-track' sign,Omentum`s 'package' sign, ' Stuffing' sign and ' Gather' sign and segmental or partial bowel wall thickening,expansion,intestinal paralysis,limited effusion between intestinal,the ascites of 43 cases were found by ultrasound but failed to find by X-ray.Conclusions In the diagnosis of intestinal perforation, 'free gas' could be found by joint application of low and high frequency ultrasound but could not do that using Xrays.There was an important value to locate intestinal perforation.It provided an important basis for clinical diagnosis and treatment.

关 键 词：低频 高频 超声 穿孔 

分 类 号：R445.1[医药卫生—影像医学与核医学] R656[医药卫生—诊断学]