超声间接征象对急性阑尾炎的诊断价值

Diagnostic value of indirect signs of ultrasound in acute appendicitis

目的:探讨超声间接征象对急性阑尾炎的诊断价值。方法:回顾性分析在灌云县人民医院手术及病理证实的112例急性阑尾炎患者,分析其声像图间接征象:(1)右下腹探头压痛或反跳痛;(2)回盲部肠壁水肿;(3)回肠末段蠕动增强;(4)右下腹局限性肠间隙积液;(5)右下腹片状强回声;(6)右下腹肠系膜淋巴结肿大;(7)右下腹气体多次反射回声。并将其与阑尾炎病理分型对出对比分析。结果:超声检查中显示阑尾88条;急性阑尾炎时超声间接征象检查阳性率分别为:(1)右下腹探头压痛或反跳痛98例;(2)回盲部肠壁水肿92例;(3)回肠末段蠕动增强50例;(4)右下腹局限性肠间隙积液65例;(5)右下腹片状强回声56例;(6)右下腹肠系膜淋巴结肿大38例;(7)右下腹气体多次反射回声22例。其中坏疽性阑尾炎检出率最高,化脓性阑尾炎居中,单纯性阑尾炎检查率最低。结论:超声间接征象能够反映阑尾周围组织炎症,正确认识超声间接征象,有助于临床对急性阑尾炎的诊断。

Objective To investigate the diagnostic value of indirect signs of ultrasound in acute appendicitis.Method A retrospective analysis with112cases of acute appendicitis patients confirmed with surgery and pathology in Guanyun People′s Hospital,the sonographic analysis of indirect signs:①Right lower abdominal tendertness or rebound tendertness;②Edema of intestinal wall in ileocecal junction;③Terminal ileum peristalsis enhancement;④Right lower abdomen limitation interloop effusion;⑤Patch of hyperecho in right lower abdomen;⑥Right lower abdomen mesenteric lymphadenopathy;⑦Right lower abdomen gas multiple reflection echo.And compared with the pathological typing of appendicitis.Results88appendix ultrasonography in acute appendicitis;the positive rate of indirect ultrasonographic signs examination respectively:①98cases were with right lower abdominal tendertness or rebound tendertness;②Edema of intestinal wall in ileocecal junction in92cases;③Terminal ileum peristalsis enhancement in50cases;④Right lower abdomen limitation interloop effusion in65cases;⑤56cases of Patch of hyperecho in right lower abdomen;⑥Right lower abdomen mesenteric lymphadenopathy in38cases;⑦22cases of right lower quadrant gas multiple reflection echo′.Among them,the detection rate of gangrenous appendicitis was the highest,suppurative appendicitis was the middle,and the rate of simple appendicitis was the lowest.Conclusion The indirect signs of ultrasound can reflect the inflammation of the tissues around the appendix.It is helpful for the diagnosis of acute appendicitis.