消化道穿孔患者腹腔感染CT的诊断价值分析

The clinical value evaluation of CT in diagnosing gastrointestinal perforation patients with abdominal infections

目的探讨CT在诊断消化道穿孔患者腹腔感染中的临床价值,提高腹腔感染的早期诊断率。方法回顾性分析2011年1月-2014年11月经临床、手术或生化检查证实为消化道穿孔腹腔感染患者77例治疗前的CT图像,观察内容包括积气、腹水、腹腔脓肿等征象,总结消化道穿孔合并感染的CT诊断征象。结果 77例中胃穿孔28例、十二指肠穿孔35例、阑尾穿孔11例、肠穿孔3例;腹腔积气是诊断穿孔的主要征象,其中51.9%的病例表现为大量积气,40.3%表现为少量积气;腹水和渗出是诊断腹腔感染的常见征象,约41.6%的病例腹腔内出现了明显的腹水,81.8%的病例均可见渗出性改变,腹膜增厚、腹腔脓肿及肿大的淋巴结等征象也支持腹腔感染。结论 CT在消化道穿孔患者腹腔感染的诊断中具有一定的价值,其中腹腔积气和渗出性改变是诊断该病的主要征象。

OBJECTIVE To explore the clinical value of CT in diagnosing the gastrointestinal perforation with ab‐dominal infections ,so as to improve the early diagnosis of abdominal infections .METHODS The CT images of 77cases of patients who were proven to suffer from gastrointestinal perforation by clinical signs ,surgery and bio‐chemical examinations from Jan .2011 to Nov .2014 were retrospectively analyzed ,which included intraperitoneal gas ,ascites ,abdominal abscess and so on ,and the main CT findings in diagnosing the gastrointestinal perforation with abdominal infections were concluded .RESULTS There were 28 cases proven to have gastric perforation ,35 cases proven to have duodenal perforation ,11 cases proven to have appendix perforation and 3 cases proven to have intestinal perforation in the 77cases .Gas in intraperitoneal was the main feature in diagnosing the gastrointestinal perforation ,and 51 .9% of 77 cases showed numerous intraperitoneal gas and 40 .3% of 77 cases showed little in‐traperitoneal gas .Ascites and exudative were the main features in diagnosing the abdominal infections .Totally 41 .6% cases showed apparent ascites and 81 .8% cases showed exudate changes in peritoneum .In addition ,peri‐toneal thickening ,abdominal abscess and swelling of the lymph nodes and other signs also were the signs of ab‐dominal infections .CONCLUSION CT has certain clinical value in diagnosing the gastrointestinal perforation with abdominal infections ,and the main findings of CT is abdominal gas and peritoneal exudate changes .