螺旋CT鉴别术后粘连性腹内疝及肠梗阻的价值

The value of spiral CT in identifying postoperative adhesive intra-abdominal hernia and intestinal obstruction

目的探讨多排螺旋CT鉴别粘连性腹内疝与单纯粘连性肠梗阻的价值。方法收集粘连性腹内疝19例(腹内疝组)和粘连性肠梗阻25例(肠梗组),回顾性分析两组患者CT表现的差异,分析有统计学差异(P<0.05)的CT征象对腹内疝和粘连性肠梗阻的鉴别诊断价值。结果梗阻点明确、粘连带、鸟嘴征、环靶征、肠系膜雾样征、缆绳征在腹内疝组出现频率高于粘连组(P<0.05),预测粘连性腹内疝比值比分别为:18.06、3.56、15.00、6.86、4.40、21.33,但粘连带征OR的95%可信区间跨越1。多因素回归分析显示缆绳征对腹内疝鉴别有显著性(P<0.05)。结论多排螺旋CT对粘连性腹内疝与粘连性肠梗阻的鉴别有重要的临床意义。

Objective To explore the value of multi-slice spiral CT(MSCT)in the identification of adhesive intra-abdominal hernia and simple adhesive intestinal obstruction.Methods CT findings between 19 cases of adhesive abdominal hernia(internal hernia group)and 25 cases of adhesion intestinal obstruction(intestinal obstruction group)collected were analyzed retrospectively,and the identification value of signs of CT with statistical difference(P<0.05)on intra-abdominal hernia and adhesive intestinal obstruction was analyzed.Results The clear obstruction points,adhesive zone,signs of beak,target,misty mesentery and cable in the internal hernia group showed higher frequency(P<0.05)than in the intestinal obstruction group,and their odds ratio(OR)of adhesive intra-abdominal hernia was 18.06,3.56,15.00,6.86,4.40 and 21.33 respectively,but 95%confidence interval of the OR of adhesive zone spanned 1.Multi-factor regression analysis showed that the cable sign was significant(P<0.05)in identifying intra-abdominal hernia.Conclusion MSCT has important clinical significance for the identification of adhesive intra-abdominal hernia and adhesive intestinal obstruction.