小肠梗阻病因诊断方法的临床研究

Clinical study on the etiologic diagnosis method of small bowel obstruction

目的 评价CT检查对诊断小肠梗阻病因的临床价值.方法 纳入2010年1月至2013年9月经手术证实为小肠梗阻的237例患者,收集所有患者的临床资料.比较腹部彩色超声检查和腹部CT检查在明确梗阻部位、梗阻病因和绞窄性梗阻判断中的阳性发现.计数资料的比较采用卡方检验.结果 237例小肠梗阻患者中,同时具备腹部彩色超声检查和腹部CT检查资料的患者有121例.经手术证实,腹部CT在明确梗阻部位、梗阻病因,以及绞窄性梗阻判断上的准确率分别为75.2％（91/121）、66.1％（80/121）、87.2％（41/47）,分别高于腹部彩色超声的44.6％（54/121）、30.6％（37/121）、42.6％（20/47）,差异均有统计学意义（χ2=23.555、30.595、20.593,P均＜0.01）.结论 腹部CT检查诊断小肠梗阻的部位、病因及绞窄的准确率高于腹部彩色超声检查,尤其在明确梗阻病因上具有明显的优势.

Objective To evaluate the clinical value of computed tomography （CT） examination in the etiologic diagnosis of small bowel obstruction.Methods From January 2010 to September 2013,a total of 237 patients with small bowel obstruction confirmed by operation were enrolled.The clinical data of all patients were collected.The diagnostic value of color Doppler ultrasound and abdominal CT examination were compared in estimating site of obstruction,etiology of obstruction and strangulation obstruction.Chi square test was performed for count data comparison.Results Among 237 patients with small bowel obstruction,there were 121 patients with data of both color Doppler ultrasound and abdominal CT examination.After operation,it was comfirmed that the accurate diagnosis rates of abdominal CT scan in the site of obstruction,the etiology of obstruction and strangulation obstruction were 75.2 % （91/121）,66.1% （80/121） and 87.2% （41/47）,respectively,and which were higher than those of abdominal color ultrasound （44.6%,54/121; 30.6%,37/121 and 42.6%,20/47）.The differences were statistically significant （x2 =23.555,30.595 and 20.593,all P〈0.01）.Conclusion The accurate diagnosis rates of abdominal CT scan in estimating the site of obstruction,the etiology of obstruction and strangulation obstruction were higher than those of color Doppler ultrasound,especially with obvious advantage in judging the etiology of obstruction.