缺血性肠病患者腹部CT影像特点分析

Analysis for abdomen CT characteristics of patients with ischemic bowel disease

目的分析缺血性肠病(ICBD)患者的腹部CT影像特点。方法回顾性分析2008年1月-2013年12月解放军总医院确诊并行腹部CT检查的ICBD患者的CT影像资料,并将其按不同结局分为生存组和死亡组,探讨与ICBD死亡相关的肠道病变的CT影像特点。结果共纳入ICBD患者151例,其中急性肠系膜上动脉血栓栓塞(ASMATE)51例,急性肠系膜上静脉血栓(ASMVT)53例,非闭塞性肠系膜缺血(NOMI)8例,慢性肠系膜缺血(CMI)10例,缺血性结肠炎(IC)29例。其中生存组115例,死亡组36例,结果显示死亡组腹腔积液、门脉系膜积气、肠壁积气及腹腔游离气体比例均明显高于生存组(P<0.001,P<0.001,P<0.001,P=0.003)。结论腹部CT显示腹腔积液、门脉系膜积气、肠壁积气及腹腔游离气体等与ICBD患者预后有关。

Objective To investigate the abdomen CT characteristics of patients with ischemic bowel disease（ICBD）.Methods CT imaging data of ICBD patients from January 2008 to December 2013 in the Chinese PLA General Hospital were retrospectively analyzed to find CT imaging features in intestinal lesions associated with ICBD death. Results In CT imaging analysis, 151 patients including acute superior mesenteric artery thromboembolism（ASMATE, n=51）, acute superior mesenteric vein thrombosis（ASMVT, n=53）, non-occlusive mesenteric ischemia（NOMI, n=8）, chronic mesenteric ischemia（CMI, n=10）and ischemic colitis（IC, n=29） were divided into survival group（n=115） and death group（n=36）. In comparison with the survival group, the death group had higher incidence of abdomenal effusion, portomesenteric gas, pneumatosis intestinalis and pneumoperitoneum（P〈0.001, P〈0.001, P〈0.001, P=0.003）. Conclusion The ascites, portomesenteric vein gas, pneumatosis intestinalis and pneumoperitoneum in bowel CT may be associated with the death of ICBD patients.