192例急性阑尾炎的超声诊断分析

Results of applying ultrasound to diagnosis of acute appendicitis in 192 cases

目的：比较低频、高频超声在诊断阑尾炎的病理类型以及肿大阑尾位置上的差异,分析其临床意义。方法：选择我院2013年3月~2015年3月行阑尾炎手术患者共192例,记录术前超声检查数据,结合术中情况和术后病理进行分析。结果：超声对急性阑尾炎的诊断率为87.5%,其中急性单纯性阑尾炎（62.5%）与急性化脓性阑尾炎（98.4%）的诊断率差异有统计学意义（P〈0.01）;高频超声（85.9%）与低频超声（46.9%）的诊断率差异有统计学意义（P〈0.01）;超声提示的阑尾位置与术中阑尾位置符合率为66.1%,其中回肠前位（90%）与盲肠后位（58.7%）和回肠下位（62.5%）的符合率差异有统计学意义（P〈0.01）。结论：超声可以提示阑尾炎的病理类型以及肿大阑尾的位置,高频超声对阑尾炎的诊断率明显优于低频超声,超声表现可作为临床医生诊断阑尾炎有力的影像学依据。

Objective： To compare the pathological pictures and the position of enlarged appendix detected with low and high frequency ultrasound,and analyze the clinical significance of this diagnostic modality. Methods： 192 patients with acute appendicitis undergone surgical treatment in our hospital between March of 2013 and 2015 were included,and the clinical data were retrospectively examined regarding the preoperative ultrasonography by low and high frequency,intra-operative and post-operative pathological findings. Results： Overall,ultrasonography had made 87. 5% of accurate diagnosis of acute appendicitis,in which the diagnosis rate was 62. 5% for simple acute appendicitis and 98. 4% for acute purulent appendicitis（ P〈0. 01）. The coincidence rate was also different between high frequency ultrasonography（ 85. 9%） and low frequency ultrasonography（ 46. 9%）（ P〈0. 01）. The position of enlarged appendix indicated by ultrasonography was coincided with intraoperative findings in 66. 1% of the cases,and particularly the difference was significant pertaining to the location at anterior ileum（ 90%）,retrocecal position（ 58. 7%） and inferior iliac position（ 62. 5%）（ P〈0. 01）. Conclusion： Ultrasonography can exhibit the pathological type of appendicitis and the location of the enlarged appendix,and high frequency ultrasound may have a higher diagnostic accuracy than the low frequency ultrasound,suggesting that ultrasonic presentation can be useful arm for clinicians in diagnosis and treatment of appendicitis.