结肠镜、多层螺旋CT在肠梗阻病因诊断中的应用价值

Evaluation of colonoscope and MSCT in etiological diagnosis of ileus.

目的探讨结肠镜、多层螺旋CT在肠梗阻病因诊断中的应用价值。方法回顾性分析146例经腹部平片、手术证实肠梗阻患者的结肠镜、多层螺旋CT资料。结果146例肠梗阻.结肠梗阻68例，小肠梗阻73例，未明确5例。结肠镜检查73例：其中结肠肿瘤41例，结肠息肉6例，结肠套叠8例，乙状结肠扭转2例，回肠末段肿瘤3例，未见异常13例。多层螺旋CT检查78例：其中小肠粪块22例，粪石2例，肠腔外淋巴瘤4例，肠系膜血栓形成1例，小肠肿瘤26例，原因未明23例。治疗情况：保守治疗30例，结肠镜下乙状结肠扭转复位2例，肠套叠空气灌肠复位3例，内镜下结肠息肉高频电切除术6例，手术治疗105例。死亡6例，康复140例。结论应用结肠镜、多层螺旋CT检查有助于更好作出肠梗阻的病因诊断。

Objective To explore the value of Electronic colonoscope in the Etiologica Diagnosis of Intestinal obstruction. Methods The colonoscope,CT etc. assistance cheek result and treatment circumstance etc. Clinical data of 146 ileus patient＇s were studied retrospectively. Results 146 ileus,colon tumor 52 ;Colon polyp 10 ; The colon set folds 11 ; The sigmoid colon turns round 2 ;ileum tumor 5 ; The colonoseope check discovers the pathological changes all amount 80, having 54.8% assurance in order to cause the intestinal obstruction cause of disease 70, have 47.9%. The colonoscope cheek didn＇t see a pathological changes 66 have 45.2%. Keep to cure 57,include a colonoscope to descend sigmoid colon to turn round to reset 2 ; The bowel set folds air to infuse bowel to reset 3;Inside mirror＇s descending colon polyp a high frequency electricity resection is 7. The surgical operation cures 99 ,the diagnoses after operation colon tumor 55 ;The colon set folds 8,3 among those examples cause a bowel set to fold for the colon tumor;Colon polyp 3 ;Small intestines muck piece 9;Persimmon stone 2 ; Bowel chamber outside lymphoid lump 4;The bowel fastens film blood to bolt to become 1 ;The small intestines tumor is 17,6 persons died;140 persons recovered from illness. Conclusion The colonoscope and MSCT cheek is advantageous to the Intestinal obstruction pathological changes part of the first step judgment ： Small intestines, colon or bowel outside pathological changes.