多层螺旋CT与超声检查诊断急诊上消化道穿孔的临床价值分析

Clinical value of multi slice spiral CT and ultrasonography in the diagnosis of emergency upper gastrointestinal perforation

[目的]对比多层螺旋CT与超声检查诊断急诊上消化道穿孔的临床价值。[方法]采用回顾性研究方法,选择2012年2月~2016年8月在我院急诊诊治的上消化道穿孔患者80例作为研究对象,所有患者都给予多层螺旋CT与超声检查,记录影像学特征,对比检出率。[结果]超声检出上消化道穿孔71例,检出率为88.8%,CT检出上消化道穿孔79例,检出率为98.8%,CT对于上消化道穿孔的检出率明显高于超声(P<0.05)。超声诊断为少量腹腔积液60例,中量腹腔积液15例,大量腹腔积液5例;大量气腹50例,少量气腹22例,无气腹8例。CT诊断为大量气腹50例,少量气腹26例,无气腹4例;腹腔少量积液60例,中量腹腔积液16例,大量腹腔积液4例。[结论]上消化道穿孔是严重的急腹症,多层螺旋CT的应用可观察到超声不能发现的腹腔内积液和游离气体,从而为上消化道穿孔提供了更准确的影像学检查手段,有很好的应用价值。

[Objective]To compare the clinical values of multi slice spiral CT and ultrasonography in the diagnosis of emergency upper gastrointestinal perforation. [Methods]A retrospective study was conducted to select 80 patients with upper gastrointestinal perforation in our hospital from 2012-02 to 2016-08,all patients were received multi-slice spiral CT and ultrasonography diagnosis,recorded the imaging features,the detection rate of two ways were contrasted. [Results]Seventy-one upper digestive tract perforation patients were detected by ultrasound,the detection rate was 88.8%. And 79 upper digestive tract perforation pa- tients were detected by CT,the detection rate was 98.8% ,the detection rate of CT for the upper digestive tract perforation was significantly higher than that of ultrasound（P〈0.05）. Ultrasound diagnosis of 60 pa- tients of small amount of ascites,15 patients were in the amount of ascites,5 patients were massive ascites; the large number of pneumoperitoneum were 55 patients,22 patients were small gasless pneumoperitone- urn,8 patients were no gasless pneumoperitoneum. CT diagnosed small amount of ascites was 60 patients, 16 patients was ascites,4 patients was large amount of ascites. The large number of pneumoperitoneum was 50 patients,small amount of pneumoperitoneum was 26 patients,and 4 patients were without pneumoper- itoneum. [Conclusion]Upper gastrointestinal perforation is a severe acute abdomen. The multi-slice spiral CT can be observed in the application of ultrasound can not be found by free intraperitoneal gas and peritoneal effusion. It can provide more accurate imaging means for the upper digestive tract perforation and has good application value.