多层螺旋CT胸腔容积测定技术在食管裂孔疝患者临床诊治中的应用体会

Clinical application of multi-slice spiral CT thoracic cavity measurement in clinical diagnosis and treatment of patients with esophageal hiatal hernia

目的探讨多层螺旋CT胸腔容积测定技术在食管裂孔疝临床诊治中的应用,以提升临床医师诊断及鉴别诊断能力。方法回顾性分析2015年11月～2017年3月,在新疆维吾尔自治区人民医院微创外科手术治疗的28名食管裂孔疝患者的一般资料,总结多层螺旋CT胸腔容积测定技术在食管裂孔疝患者临床诊治中的方法及体会。结果28例患者均在术前均进行了多层螺旋CT胸腔容积测定评估,疝囊容积30.1～1 031.7(429.8±251.6)cm3,胸腔容积2 136.9～6 454.3(4 932.6±970.2)cm^3,疝囊/胸腔容积比值0.62～21.81(9.20±5.76)%。排除禁忌症后均接受腹腔镜食道裂孔疝补片修补术+胃底折叠术,手术顺利,患者术后满意度100%,术后未出现血气胸、脓胸、胃食管穿孔出血等严重并发症;所有患者均术后随访半年未见复发。结论多层螺旋CT胸腔容积测定技术在该病的临床诊治中参考价值高,简单易行,实施安全范围广。

Objective To investigate the clinical application of Multi-slice spiral CT in the measurement of the thoracic cavity volume of esophageal hiatal hernia. Methods To retrospectively analyze the general information of 28 patients with esophageal hiatal hernia,Multi-slice spiral CT was used to measure the volume of the thoracic cavity and the volume of the hernial sac. The ratio of esophageal hiatal hernia sac in thoracic cavity volume was automatically calculated. Results All 28 patients underwent multi-slice spiral CT thoracic cavity measurement before operation. Hernial sac volume is 30. 1 ～1 031. 7（429. 8 ± 251. 6）cm^3, Thoracic volume is 2 136. 9 ～6 454. 3（4 932. 6 ±970. 2）cm^3.The ratio of esophageal hiatal hernia sac in thoracic cavity volume is 0. 62 ～21. 81（9. 20 ±5. 76） %. All patients underwent laparoscopic hiatal hernia repair and fundoplication, The postoperative satisfaction rate was 100%, without serious complications of pneumothorax, empyema, gastric esophageal perforation hemorrhage; All patients were followed up for half a year without recurrence. Conclusion The multi-slice spiral CT thoracic cavity measurement technique has high reference value in the clinical diagnosis and treatment of the disease, it is simple and practicable, The implementation of a wide range of security.