超声检查在外伤性胃肠穿孔诊断中的应用价值

Application value of ultrasonography in diagnosis of acute traumatic gastrointestinal perforation

目的 探讨超声对外伤性胃肠穿孔的诊断价值。方法 回顾性分析我院98例经手术证实的外伤性胃肠穿孔患者术前超声和X线结果,比较两者对腹腔游离气体检出率、外伤性胃肠穿孔的检出率及定位诊断符合率。结果 ①超声与X线对腹腔游离气体检出率分别为52.0%、71.4%,二者比较差异有统计学意义(χ2=7.797,P<0.05);②超声定位诊断符合率82.6%,而X线不具备定位诊断能力;③超声与X线对外伤性胃肠穿孔检出率分别为87.8%、71.4%,二者比较差异有统计学意义(χ2=8.410,P<0.05)。结论 超声对腹腔游离气体的检出率虽不及X线,但根据破裂口位置、异常包块部位、大网膜聚集方向等表现,对外伤性胃肠穿孔综合检出率较X线高,并能进行穿孔部位定位诊断,综合诊断能力优于X线。

Objective To explore the diagnostic value of uhrasonography in acute traumatic gastrointestinal perforation. Methods Preoperative ultrasonic images and X-ray findings in 98 patients with traumatic gastrointestinal perforation which confirmed by operation were analyzed retrospectively. The positive rate of intraperitoneal free air, the detection rate of acute traumatic gastrointestinal perforation and the coincidence rate of localization diagnosis were compared between the two methods. Results（1）The detection rates of intraperitoneal free air by ultrasonography and X-ray were 52.0% and 71.4%, respectively. There was a significant difference between the two methods （χ^2=7.797,P〈0.05）. （2）The coincidence rate of localization diagnosis by uhrasonography was 82.6%, but X-ray hadn＇ t the ability of localization diagnosis. （3）The detection rates of acute traumatic gastrointestinal perforation by uhrasonography and X-ray were 87.8% and 71.4%, respectively. There was a significant difference between the two methods（χ^2=8.410, P〈0.05）. Conclusion Though the detection rate of intraperitoneal free air by uhrasonography is lower than that by X-ray, the comprehensive detection rate is higher. By various kinds of direct and indirect signs, ultrasonography can make comprehensive localization diagnosis for traumatic gastrointestinal perforation. Ultrasonography is superior to X-ray in comprehensive diagnose of traumatic gastrointestinal perforation.