超声检查在消化道穿孔诊断中的价值

Value of Ultrasonography in Diagnosis of Gastrointestinal Perforation

目的探讨超声检查在诊断消化道穿孔中的临床价值和体会。方法对2009年1月至2012年1月东莞市大朗医院收治的48例经手术病理证实的急性消化道穿孔患者的临床资料及超声表现进行回顾性分析。结果超声检查发现腹腔游离气体和游离包裹性积液的敏感性分别为85.4%(41/48)和87.5%(42/48);X线检查发现膈下游离气体的敏感性为75.0%(36/48)。结论超声检查可诊断出胃肠穿孔时腹腔内游离气体、积液以及异常回声等征象,弥补了X线检查的不足,为临床外科急腹症的快速诊断提供可靠依据。

Objective To investigate the value of ultrasonography in the diagnosis of gastrointe-stinal perforation.Methods Clinical and ultrasound features of 48 patients with pathologically confirmed acute gastrointestinal perforation who were treated in Dalang hospital of Dongguan between January 2009 and January 2012 were analyzed retrospectively.Results The sensitivity of detection of free intraperitoneal air and free perforation fluid by ultrasonography was 85.4%（41/48）and 87.5%（42/48）,respectively.The sensitivity of detection of subdiaphragmatic free air by X-ray examination was 75.0%（36/48）.Conclusion Ultrasonic examination can detect free intraperitoneal air,fluid and irregularly shaped mass to make up for the deficiencies of the X-ray examination in patients with gastrointestinal perforation,suggesting that ultrasonography can provide a reliable basis for rapid diagnosis of acute abdomen.